Treatment of Borderline Personality Disorder: Medication

Something that has been on my mind a lot lately. Treatment. So let’s take a leap down the rabbit hole and see where treatment for Borderline Personality Disorder takes us.
There are 4 basic strategies that are utilized for treatment of Borderline Personality Disorder: Psychotherapy, Medication, Hospitalization, and Self-Help strategies. Over the next few days I’ll start on the last 3 and then I’ll just take a dive into some of the therapeutic techniques that my therapist specializes in, what we work on, and what is beneficial for Borderline…. And not. Because let’s face it, every person is different, every disorder is different, and some strategies just don’t work well enough on their own to be effective for every case.

Psychotherapy forms the foundation of treatment for borderline personality disorder with medications playing a lesser role. While there is no known medication that can target Borderline Personality Disorder on its own, prescription medications can address many of the common symptoms of BPD. This is something my Psychiatrist told me upon diagnosis. There is no medical cure for Borderline Personality Disorder. However, we can work to manage some of the symptoms and co-morbid occurring issues in order to improve quality of life and aid psychotherapy so that treatment will be successful.
Medications typically used in the treatment of BPD include antidepressants, mood stabilizers, anti-anxiety drugs, and antipsychotics.
 Antidepressants Used for the Treatment of BPD Symptoms
A variety of antidepressants have been studied for use in treating the low moods, sadness, and depression that can occur with BPD, including the following:
          Fluoxetine (Prozac)** <~~~~ Check
          Sertraline (Zoloft) <~~~~ Check
          Citalopram (Celexa)
          Escitalopram (Lexapro) <~~~~ Check
Mood Stabilizers Used for the Treatment of BPD Symptoms
Medications with mood-stabilizing properties, such as lithium and some anticonvulsant (anti-seizure) medications, can help address the impulsive behavior and rapid emotional changes associated with BPD.
Mood stabilizers used to treat the symptoms of BPD may include:
          Divalproex sodium (Depakote)
          Lithium carbonate (Lithobid)
          Lamotrigine (Lamictal)  <~~~~~~ Check
Anti-anxiety Medications Used for the Treatment of BPD Symptoms
Anti-anxiety (anxiolytic) medications can help with the intense anxiety some people with BPD may experience. However, there isn’t much research that supports the use of anti-anxiety drugs to treat BPD. Some research actually indicates that one class of anti-anxiety drug — benzodiazepines (e.g., Ativan, Klonopin) — may actually worsen BPD symptoms for some people.
Examples of anti-anxiety medications used to treat the symptoms of BPD include:
          Alprazolam (Xanax) <~~~~~ Check
          Clonazepam (Klonopin) <~~~~~ Check
          Lorazepam (Ativan)
          Diazepam (Valium)
          Buspirone (Buspar)
Antipsychotic Medications Used for the Treatment of BPD Symptoms
Antipsychotic medications can help address occasional breaks from reality as well as the paranoia, anger, or hostility that people with BPD may experience.
Some antipsychotics used to treat BPD include:
          Olanzapine (Zyprexa)** <~~~~ Check  
          Risperidone (Risperdal) <~~~~ Check
          Aripiprazole (Abilify) <~~~~ Check
          Haloperidol (Haldol)
          Paliperidone (Invega)
** Symbyax was the atypical anti-psychotic Psychiatrist had me on. It’s a combination of Olanzapine and fluoxetine.
My medication-go-round has been a bit exhausting. And by a bit, I mean, I am more tired and have less energy now than I have ever had in my life, even in my worst depression. At my lowest point I’m still a very high-functioning person and could at least stick to my routines of get up, go to work, go to the gym, shower, eat, bed. At the very least. I no longer have the energy to go to the gym, which makes me have even less energy to do anything else. I have begun to lose my motivation for the things I love. I just feel weighed down by everything. The weather has even cooled down a little so there’s no attributing it to the heat. My only conclusion is that it’s the medication because, surprise, that’s when I started to feel so off.
I understand why Psychiatrist put me on the Symbyax even though it ended up exacerbating my eating disorder. I was harming myself and bordering on suicidal and he wanted something that would help me immediately. Unfortunately this was not good for me in the long run. The Lamictal didn’t work at all. Because of the issues with the Symbyax I’m afraid of anti-psychotics but agreed to the Abilify.

I do feel a little more stable, but I also feel deadened and weighed down. Nothing is as fun, nothing is as beautiful, being with people is not as enjoyable, I don’t feel love and I can’t get swept away. This is not the kind of stability I’m looking for. I’m constantly fatigued. Getting out of bed and sitting upright are a chore. I’m losing my desire to do things I love. I look forward to the day ending so I can sleep. Then when I wake up all I want to do is continue sleeping. This. Is not me.  This has never been me. I refuse to accept that this is how I should be. Friend once told me that the meds might just be making me ‘normal’, “now you’re just not a superwoman, you have a normal person’s energy, you’ll get used to it”. If this is the energy level that normal people have than no wonder our country is so slow. I hate it. I am not a slow person. I think sometimes they like me on these meds because they don’t feel so bad being lazy themselves. The meds are bringing me down to their level and it makes them feel better about their own short comings. Screw that. Or I’m paranoid. (indicator of meds not working? Eh?) Whatever.
I’d rather be a little crazy but fully functional, then mostly ‘normal’ and utterly immobile.
I’m going to talk to Psychiatrist tomorrow about going off medication. At least for the rest of the summer. Give it a trial run. See if my energy ramps back up. If it does, then it’s definitely the medication that’s slowing me down and I’ll know. Which means what I’m on is not ok for me. If I continue to feel this way off the medication than there’s something else going on and I may have to go back to two sessions of therapy a week to work on stuff. It’s a process. I’m still open to the possibility of medication, but right now I feel I need to reestablish my baseline and get myself back to a healthy normal for my body. The funny thing about taking care of your body, your mind usually follows….
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Did you see that? – Hallucinations, Distortions and Hypnogogia

I have so much I want to post all at once =( I completely forgot to post my Lucid Analysis from therapy this week (stupid busy at work this week and I didn’t have time to post Monday so now my whole schedule is thrown off). I may do that tomorrow because it was a rather insightful session. 
So continuing on with the Associated Features of Borderline Personality Disorder.
(B) Some individuals develop psychotic-like symptoms when under stress:
Ex.
          Hallucinations
          Body image distortions, ideas of reference
          Hypnagogic phenomena  
Hallucinations: I can’t personally speak for hallucinations. I have never had this problem except for one time and an experience involving Absinthe, but that really has nothing to do with BPD. Friends wife has, on occasion, experienced bipolar related hallucinations. They can be visual, auditory, or sensory. Unless you consider that bugs crawling on your skin sensation a hallucination when there aren’t any bugs there. I’ve had that before, but only after I found an actual bug crawling over me and was a little ooged out.
Body image distortions: I’m not even going to expound on my issues with body image and dysmorphia. You can read about it more here. In terms of self-perception I have almost no concept of how I physically relate to another person from a physical measurements point of view. People and myself are measured by their presence in my mind. If I don’t have any respect for you, you can be 6’7” and 300lbs but you’ll register as someone nonthreatening and therefore smaller. If you’re someone I do have a great deal of respect or caring for, in my eyes you will seem taller.  Additionally, my perception of myself (has nothing to do with this), I just always think I am bigger than I am. No, not in an “I’m so fat”, kind of way. I need to physically stand side by side someone looking into a mirror to get an accurate idea of just how discrepant our sizing is. Otherwise I feel like I’m of a proportion similar to them or that their sizing is more ideal than my own. I don’t think I’m describing this well, it’s hard for me to convey. It’s a sense that I am not proportionate to those around me.
Ideas of Reference: involve people having a belief or perception in which irrelevant, unrelated or innocuous phenomena in the world refer to them directly or have special personal significance: ‘the notion that everything one perceives in the world relates to one’s own destiny’.  
Not my issue. I pretty much believe my place in this universe is innocuous in itself and I don’t believe in destiny at all. I am in control (or should be) of my own future.  To me this is something of a paranoid feature and my paranoia just doesn’t extend that far.
Hypnagogia is the transitional state between wakefulness and sleep (i.e. the onset of sleep).
I find this one rather fascinating… among its many names, it’s also referred to as the Borderland state. Fitting, eh? I have a lot of hypnogogic phenomena.
Transition to and from sleep may be attended by a wide variety of sensory experiences. These can occur in any modality, individually or combined, and range from the vague and barely perceptible to vivid hallucinations.
Sights – sensory features of hypnagogia are phosphenes which can manifest as seemingly random speckles, lines or geometrical patterns, including form constants, or as figurative (representational) images.
 I can’t figure out if this means with eyes open or closed. I assume closed because it’s the state between wakefulness and sleep. For me I have like this awful web of black tar that coats everything behind my eyes. It’s utterly bizarre. I just had this sense last night. I remember thinking it’s been quite a while since I’ve seen this.
Tetris Effect – People who have spent a long time at some repetitive activity before sleep, in particular one that is new to them, may find that it dominates their imagery as they grow drowsy, a tendency dubbed the Tetris effect. When the activity involves moving objects, as in the video game Tetris, the corresponding hypnagogic images also tend to be perceived as moving. The Tetris effect can be tactile as well.
I don’t really get this one, but it seems neat.

Sounds – Like the visuals, hypnagogic sounds vary in intensity from faint impressions to loud noises, such as crashes and bangs (exploding head syndrome). People may imagine their own name called or a doorbell ringing. Snatches of imagined speech are common. While typically nonsensical and fragmented, these speech events can occasionally strike the individual as apt comments on—or summations of—their thoughts at the time. They often contain word play, neologisms and made-up names. Hypnagogic speech may manifest as the subject’s own “inner voice”, or as the voices of others: familiar people or strangers. More rarely, poetry or music is heard.
I don’t know if I hear anything in particular when I’m hypnogogic, but I’ve been told I talk in my sleep. Clearly and often.  My Roommate, Friend, lovers, family have all told me that I talk in my sleep. As far as I can tell it’s most often at this point of bordering on sleep. Hey, it’s better than snoring I guess (which I’m told I do not do). 
Sleep paralysis – Humming, roaring, hissing, rushing, zapping, and buzzing noises are frequent in conjunction with sleep paralysis (SP). This happens when the REM atonia sets in sooner than usual, before the person is fully asleep, or persists longer than usual, after the person has (in other respects) fully awoken and causes them to be unable to move their body and limbs.
It’s not permanent, but it can certainly be a little disconcerting. I’ve never had this but some friends have mine have mentioned it.
Lucid Dreaming – This is  my favorite. Lucid dreams are dreams in which you are aware that you are dreaming. In a lucid dream, the dreamer can actively participate in and manipulate imaginary experiences in the dream environment. Lucid dreams can seem real and vivid. There are a couple different kinds and I experience both:
A dream-initiated lucid dream (DILD) starts as a normal dream, and the dreamer eventually concludes it is a dream.
A wake-initiated lucid dream (WILD) occurs when the dreamer goes from a normal waking state directly into a dream state, with no apparent lapse in consciousness.
I love dreaming. The dream world is one of my favorites to occupy. To feel your body moving through a world foreign to the one it’s actually settled in, it’s, trippy. Lucid dreaming can be cultivated by anyone really, not just those with PDs or some mental taxation. I highly recommend it.  
None of these are specific to or exclusive to Borderline Personality Disorder. Not by any stretch of the imagination. However they’re often triggered by stress and anxiety and being Borderline pretty much means you’re more prone to these triggers than average.

Lucid Analysis: Trials in Therapy – 4

Monday was a good therapy session. Again, not one I got incredibly worked up over but productive none the less.
We talked about how my recent trip home to see my family affected me, how it triggered me.
My mom especially. My dad doesn’t seem to have an incredible interest in what’s going on with me. He really doesn’t engage me or start conversations with me unless I start talking first. I wonder if this is because my issues make him uncomfortable. Hm, I’m actually just realizing this as I type. My mom however starts talking to me the second I’m within sight and does not shut up. She automatically inspires the most irrational anger in me. I know this is a byproduct of my growing up and probably because she was so ‘interested’ in my life. Instead of talking to me, she’d search for my journals and read them.  I don’t trust her at all. She’d then talk to me about it, tell me of her disapproval (to be fair a lot of that disapproval was justified) and sometimes ground me for things that I did, instead of talking to me and helping me go about things in a better way. Act more appropriately. It cultivated my mistrust of her. That she takes such an interest in my life now still makes me very angry, because it feels intrusive to me even though I know she just cares. Trigger.
I was very closed off to them, to everyone. I refused to talk about my feelings, I refused to ask for help, I refused to get help. Since I was 12-ish for sure. Even before this though I was afraid that asking for help would mean I wasn’t good enough, would be a sign of weakness in my abilities. This is a direct result of how critical my father was. Anytime I did any kind of art he would ‘critique’ it. Not in a mean way. It was always directed as a means to help me ‘improve’, but I get overly happy when he does praise me and I need to keep inspiring this so I push myself harder.
This translates into how I am now. How I need to do things for other people that make them happy, that they’ll praise me for. It’s why, despite the fact that I can be mad at Friend, and really don’t like wife, I continue to cook for them because I know it’s something I’m good at and they’ll show their appreciation for it. This is especially necessary for me because my father was such a picky eater. He only likes a few select foods so when I would make new things that I liked and the rest of my family enjoyed he would either not try it or only try a little bit and let me know that he didn’t like it. I’ve always told myself this was simply because he didn’t like a variety of things, which he doesn’t, but he has never been encouraging. Even when I make new things when I visit he always comments on how ‘it stinks up the kitchen’. Those few times though, those few rare amazing times when he has liked what I made were my proudest moments. Since he was so critical, he never just placated me, I absolutely believed the compliments he would give.  Especially when I cook, when Friend or my other friends tell me they really enjoy what I make I am filled with an extraordinary sense of happiness that I am appreciated, while at the same time I don’t necessarily believe them. Amusingly the only one I really believe is Friends wife. I ask for criticism or how I can improve on some things (I cook meat dishes for people even though I’m strict vegetarian and have no idea what meat tastes like). She’s the only one that critiques me, though she is also very impressed with my abilities and has enjoyed everything I make for them, but she’s also one of the only people I believe. (She often tells people that ‘Haven makes vegetables taste like food’ or ‘Make whatever you want it’s going to be good.) Heh, but that I seek criticism and that’s the only thing I truly believe is obviously a direct result of how my father raised me. Trigger.
We didn’t talk about my brother. That my sister is the only one in this world that I truly connect to makes her my strongest base. I was horrible to her. I took out a lot of my anger on her and she was afraid of me. Until one night I came home and saw that she had been cutting as a direct result of the pressure she felt from our father. My entire relationship with her changed that night. She was afraid to talk to them about how she felt. She was always the angel, I was the devil. As a result she felt overly pressured, incapable of doing things that would possibly make them mad. I fought with them constantly and ‘didn’t need their approval’. Clearly I rebelled against them, but they’d never abandoned me for all my horrible behavior so I was able to convince her to at least sit down and talk with them so they could understand that she needed something different. Which she was able to do. We bonded over  something so ingrained in us, understood each other on a different level than we had before and realized that we could lean on each other when we needed help. She’s my best friend in the world and I would do anything for her. I love her with everything I have. I mistrust my parents, even now.
I get incredibly anxious when my sister is late getting home. I need her to be there to feel grounded. Safe. To the extent that I don’t want to go back, be there at all, if she’s not there.
Therapist doesn’t seem to be worried about the fact that I needed to have a couple drinks to deal with the barrage of questions and interest in my life that the rest of my family inspires (holiday gathering at my relatives – all of my relatives, both sides of my family). I see my family so rarely that when I do it’s practically nonstop questions and explanations. Fortunately ( I think?) my mom’s side of the family isn’t very interested in me. I was always so rebellious, so different, that they never took an interest in me. I don’t think I talked to them at all except for my aunt telling me I looked really good and lost a lot of weight (she hasn’t seen me since I was on the Symbyax that made me gain weight).  That was nice. The rest of my family though is very interested in my new job and my mental state. I can only deal with so much. So much attention is overwhelming. So I have a couple drinks to calm down. I knew before I went over that I’d be drinking though. Therapist is much more worried about my bulimia. I’m usually very good at keeping this under control. Until the holiday gatherings start. I’ve never had trust issues with my dad’s side of the family. I actually think I connect to them better than my parents. I’m  really not sure what the exact trigger here is. My parents? My mom’s side of the family? The questions? My bulimia has always been a form of control for me, so I know it has to have something to do with feeling out of control. Why the rest of my family would make me feel so out of control is still a mystery to me currently.
Note:  Identifying those issues that trigger me is the first step in figuring out how to avoid them and control them in the future.
Emo moment
Then we talked about my Abandonment issues and why Friend going out made me so ‘unhappy’  (read: hurt, anxious, depressed, jealous, left out, unnecessary, afraid). The real problem here is that I do feel like if he has more people around he won’t need me as a friend anymore. That I won’t be so important to him. That he’ll reject and abandon our friendship. Therapist is beginning to worry that our friendship is holding me back. That he triggers my abandonment issues is not healthy. I cling to our friendship too strongly. I do forsake going out on my own to meet new people because if I do I won’t be able to spend more time with him. If I go out more our friendship won’t be as strong. He will find other people. I’ll be replaced. She wants him to tell me that he doesn’t want our friendship to end, that he won’t leave me, but he should encourage me to form new, healthy relationships outside of our friendship.  That {six} years down the line we’ll still be friends. I have no way of believing this though, because I’ve never had close proximity friendships that have lasted this long in (though I have had friendship that lasted much longer than this).  I don’t know. I don’t know if I’m ready to open myself up to anyone new yet. I’m tired of being hurt. I don’t think I can do that again right now. Therapist thinks I should though.
Homework: Stop being a hermit. Get out more, outside of going to Friends’. Cultivate new relationships.
Therapist also breached the topic of wanting family, what I thought motherly qualities should be. Not that I want to have kids, but what qualities do I believe a mother should have, and how would I display these. If, if, I were to have kids, how would I demonstrate these qualities, blah blah blah.
Point:  It’s a helpful exercise to understand where I think my family failed. How I wish they had done things differently with me. 
Finally she asked about what I’d been drawing lately. Mostly I’ve been drawing my next tattoo. She was a little concerned about this because it’s so large (will hit me under my breast, down my entire right side, and over my hip). She asked me if we needed to talk about it in further sessions. I told her ‘no’ I would get it regardless. She laughed at my ‘rebelliousness’.
Update on this Friend Abandonment issue; when I was over Monday out of nowhere he did say that I should pick up the activity and join them in the future. This made me too happy and my mood improved for the rest of the night. Then my paranoia kicked in that he’s reading my blog which would make me incredibly unhappy and probably (probably? Geezus) pissed off. Bleh. I want him to include me because he enjoys my company, not because he feels obligated to me. Then I remembered that he made this offer before I’d posted about it, so my paranoia is completely crazy and entirely composed in my own mind, but that still didn’t stop me from having a small anxiety attack.
So yeah, productive day in therapy. Long, long post. Again, sorry about the day switching for this.

Distortion: Conceptions of Borderline Personality Disorder – Part 3

Getting back to our look at Gundersons’ Conceptions of BPD… 


– Distorted thoughts/perceptions, particularly in terms of relationships and interactions with others

Ugh. Yes. These come in various forms for me. 

Wanting there to be more than there is. ::sigh:: I do this at some point, in almost every relationship, be it romantic or platonic, that I’ve ever had. There’s an time where I could fall in love with everyone I let close. If I have a significant other, this can be a fleeting moment. More often I want to be more to people than I want them to be for me. Once I’ve let someone in, once they’ve become very close to me, the relationship builds in my mind. I have a hard time distinguishing between healthy platonic love and romantic love, almost obsessive desire. I want it to become more. I see more. If there’s more, then they won’t want to let me go. They won’t walk away, won’t leave, won’t abandon me. If I’m more, if I can provide everything someone needs, they’ll need me in a way that does not make me expendable.

Or, the extreme opposite… wanting someone to want absolutely nothing more than there is. To not be any closer, to not confide in me more, to not touch me, sit near me… keep a very distinct distance. I have a very difficult time with blurry lines and familial relationships. They’re either very close, or a mile apart.
Splitting. All good. All bad. Hero or villain. I generally give people a wary benefit of the doubt at first.  I can take a lot. I can deal with a lot. I put up with a lot. Until I can’t. Sometimes this fluxuates. It depends on how things were the last time I saw someone. If I’ve been slighted, hurt, embarrassed, clearly this person doesn’t give a rats ass about me anymore. Everything we’ve been through together has been a lie. All they’ve done is use me, to torment me, to push me further from people that would actually care in an attempt to break me. They’re terrible. And so am I. If they could treat me this way, I must deserve it in some way. Right? Wrong. Or they’re wonderful, considerate, closer to me than anyone else in the world.  I can trust them completely and know they always have my best interest in mind. I’m someone of value to deserve such wonderful friends. They can do nothing wrong. Until they do. Then redeem themselves. Back and forth. There’s no middle ground. No grey area. No understanding that just because someone messes up, that it doesn’t nullify every other aspect of the relationship.

Or in some instances, and really there have been a lot…. I take so much, I absorb so much of people’s energy, believe them so good, for so long.  Give them more support than I can manage for myself, be there at all hours of the night, providing everything I can to comfort or console or provide some semblance of happiness… until they’ve sucked up all I have to give, and I can’t give anymore. Oh somewhere along the way I usually fuck something up, something not terribly important, but I’m human and it feels more important than it should be, then everything I do is wrong. Nothing I do is good enough anymore, they keep putting more on me until finally the weight of their needs and expectations and my guilt, breaks me. And they’re forever ruined to me. Once this happens, it’s done. There’s no going back, no longer anything to salvage. It’s just over. The near endless energy I have, is severed. If you’re close enough to me that I will pour every emotional ounce into you, leaving very little to take care of myself, and you refuse to allow me any flexibility to be human, I break under the pressure, and some things simply cannot be rebuilt. And I no longer want to try. I move on.
Paranoia. Paranoia isn’t such a problem for me. Well, I mean, it is, just not my biggest problem. I always think people are taking digs at me, trying to make me uncomfortable or alienate me, undermine my intelligence… but I can usually keep these thoughts controlled enough that I don’t make a scene from them. I hold them in, let them fester, and then silently implode instead of directly confronting the person(s) that make me feel this way. Which if I would do from the onset, civilly, ask if that was what they meant or if I was just interpreting it wrong, but that would be rational, and when you’re rather paranoid, well, it would also be embarrassing to show people just how paranoid you really are.
It’s always intense. Wild euphoria, heady love, blistering revenge or seething wrath. Not, slightly prickly or mildly satisfied. In between states of emotion are uncommon. Sure there are calm days. Days of relative contentment, but they’re disproportionately rare. 

I’m sure there are other ways for other people. Anyone experience other ways? These were the three things that popped out at me as I’m writing this. 

Madness of the Mind – Criteria 9 / Part 1: Paranoid Ideation

I’m skipping ahead to DSM IV criteria 9. This will be at least a four part series.
Criteria 9: transient, stress-related paranoid ideation or severe dissociative symptoms.
Just because you’re paranoid, doesn’t mean they’re not out to get you.
For a Borderline personality that has such a tenuous grasp on connectivity, every little social queue is up for interpretation. Always on the look out for a sign that abandonment looms, that what you’ve been told is a lie, any reason why the people you fear to lose are actually out to hurt you. There’s a dozen different places a turn of phrase could be taken depending on how the inflection falls or the way body language speaks. A Borderline personality will think of them all, and often settle on the worst. Expect the worse, and you can prepare for it. Hope for the best, and you’ll be disappointed. It doesn’t help that he/she is often right. Doing so a BP may also set her/himself up for that fall by creating the circumstances for that very thing to happen. Self-fulfilling prophecy.
If I have an inordinate amount of stress or very unstable relationships, then I begin to second guess everything. My hold on what people said vs. what they meant becomes nebulous. Everything has a potential double meaning. Did they really mean that? Yes? No? No. They’ve only told you this thing, allowed you in, to get your hopes up, so they can turn around and take it away, hurt you. You could lose everything you’ve struggled so hard to hold onto.
In short, I over think EVERYTHING. The downside of being too smart is it’s possible to consider too many possibilities. See every fork of every thought and ruminate on all the potential paths that could possibly be.
Normally, however, I take almost an opposite extreme. I can be too literal in my interpretation of people, thoughts, and things. I choose to accept what people say at face value and expect them to live up to their word. Don’t confuse this with trusting what people say, because I rarely do, but in order to lessen the paranoid ideation, I take words for what they are and act on them as such. This allows me to control the obsessive ruminations and removes my responsibility for when other people don’t live up to what they say.
How do you make these thoughts, stop? You can’t. At least, I’ve never found a way. Speaking up, communicating the irrational thoughts that buzz through your brain, helps. Start your sentence with, “This may not be rational but I have this {insert thought} in my brain, can you help me figure it out so I can move past it….” This way the people around you understand and can clarify an interpreted intent.