The Hard Part of Coming Home
Possible Trigger Warning: This post discusses self-harm urges and recovery.
I am not recommending self-harm as a coping mechanism. Self-harm is often a sign that additional support is needed. If you are struggling, call or text 988, or text "HOME" to 741741 to connect with someone who can help.
So...
Lately, I have been dealing with some very difficult thoughts. They have been hard to manage, and I have been relying heavily on my DBT skills to help me get through them.
I've spent a lot of time wondering why my urges have become so intense. When I first came home from residential treatment, I was doing fairly well. I had made progress and built some momentum in addressing my depression, anxiety, and trauma. The urges were still there, but they felt manageable.
Now, it feels like I am fighting for my life.
Recently, it occurred to me that there may be a reason for this. Every day in PHP (Partial Hospitalization Program), I am actively confronting my trauma and anxiety. That work is important, but it is also exhausting. At the same time, life at home is very different from life in residential treatment.
Residential treatment is a safe and highly structured environment. There are no sharps readily available, daily routines are established, and self-harm is much more difficult to act on. That's not to say it never happens there, but the environment provides many layers of protection and support.
At home, those safeguards are gone. Since returning, I have tried to jump back into the routines and responsibilities of everyday life. I am trying my best, but often I feel like I am falling short. Sometimes I wonder if I am strong enough.
More than anything, I want the urges to quiet down. I know they may never disappear completely, but even a little relief would be welcome. I am tired of fighting. I am tired of feeling this way. This has been a lifelong struggle, and there are days when the weight of it feels overwhelming.
What I want most is to feel capable of managing my emotions and urges without feeling like I am constantly battling them. I want to trust myself. I want to believe that recovery is possible.
Tomorrow is another day. Maybe it won't feel as dark as the last few days have felt. Maybe I will find a little more strength, a little more hope, and a little more peace.
For today, I will keep going.
I can do this.
And if you're struggling too, you can do this.
Suicidal Tendencies
I have been dealing with a lot lately, and I have been using my DBT skills to manage the intense urges that keep coming up. So far, I haven't acted on them, and I am proud of that. At the same time, I am exhausted from feeling this way all the time.
I want to get these urges under control. I want to feel normal. This has been a lifelong battle, and lately, it feels like I am losing.
Since January 26, 2026, I have been to EmPATH, completed residential treatment, and participated in a trauma PHP. I have put in a tremendous amount of effort, yet I still feel much the same as I did when this journey began. Sometimes it makes me wonder if any of it is working.
The truth is, I am trying. I am trying every day. But it is hard. I feel deeply sad, and even the simplest tasks can require an enormous amount of energy. Some days, just getting through the day feels like a victory.
Lately, I have noticed myself losing hope, and that is a difficult place to be. Hope is often what keeps us moving forward when progress feels invisible.
Even so, I know I have to keep trying. I have to keep using my skills, taking things one day at a time, and pushing through the moments when it feels impossible. Recovery is rarely a straight line, and sometimes the progress we make is harder to see than we would like.
For now, I am holding on to the possibility that tomorrow might feel a little better than today.
Call or text 988 | 988 Lifeline
Text “Home” to 741741 | Crisis Text Line
Self-Harm and hope
Self-harm is more common than many people realize. Unfortunately, I know this firsthand because it is something I struggle with myself.
According to the Mayo Clinic, self-injury—often called nonsuicidal self-injury (NSSI)—is the act of intentionally harming your own body, such as through cutting or burning. It is typically not a suicide attempt. Instead, it is often used as a way to cope with overwhelming emotional pain, sadness, anger, stress, or other difficult feelings.
While self-harm may provide a temporary sense of relief or release, that relief is usually short-lived. Feelings of guilt, shame, and emotional distress often return, creating a painful cycle that can be difficult to break. Although most people who self-harm do not intend to cause life-threatening injuries, the behavior can still result in serious harm.
Self-harm affects people from all walks of life, but certain groups experience higher rates than others:
Adults: About 5% of adults report having engaged in self-harm at some point in their lives.
Teenagers: Adolescents have the highest rates of self-injury, with approximately 17% reporting that they have self-harmed at least once.
College Students: Studies suggest that around 15% of college students have engaged in self-harming behaviors.
Women and Men: Women are generally more likely to report self-harm, but men may account for at least 35% of all cases. Experts believe self-harm among men is often underreported.
Sexual Minorities: Individuals who identify as gay, lesbian, or bisexual are at increased risk. Some studies have found especially high rates among bisexual women.
These statistics remind us that self-harm is not rare, and many people are struggling silently.
So, what can you do if you or someone you care about is struggling with self-harm?
The good news is that help is available. Recovery is possible, and there are many resources, treatments, and support systems that can help people learn healthier ways to cope with emotional pain. In the next section, I'll share some of the resources and strategies that have helped me and others on the journey toward healing.
Supporting a Partner Who Self-Harms | Nicole Arzt Medium.com
Self-Harm - Causes, Warning Signs, and Symptoms | Health Direct (AU)
Someone I Care About is Harming Themselves | Mental Health America
Text HOME to 741741 to connect with a live volunteer Crisis Counselor | Crisis Text Line
More Little People
So…In my spare time between exposures, I have been drawing Little People pictures. For those unfamiliar, exposure therapy is a core component of Cognitive Behavioral Therapy (CBT) and is often used to help people face fears, trauma, and anxiety in a safe and structured way.
According to the American Psychological Association, exposure therapy is:
“A psychological treatment that was developed to help people confront their fears. When people are fearful of something, they tend to avoid the feared objects, activities, or situations. Although this avoidance might help reduce feelings of fear in the short term, over the long term it can make the fear become even worse. In such situations, a psychologist might recommend a program of exposure therapy in order to help break the pattern of avoidance and fear. In this form of therapy, psychologists create a safe environment in which to ‘expose’ individuals to the things they fear and avoid. The exposure to the feared objects, activities, or situations in a safe environment helps reduce fear and decrease avoidance.”
Exposure therapy can be emotionally exhausting, and after each exposure, I have found that drawing helps me calm down and regulate my emotions. It gives me something creative and grounding to focus on after doing difficult therapeutic work.
As an added bonus, it has led to some pretty cool pictures. Here are the latest additions to my Little People collection.
Little People and a frog.
Little People in a Circle.
Little People in a Zigzag.
Little People in a Line.
300 Blues
So…for the past year and a half, I have had a painting sitting unfinished on my easel.
The unfinished painting.
As I have struggled with depression and anxiety, I slowly moved away from the things I once loved. One of those things was painting. Something that once brought me joy became something I simply stopped doing.
It wasn’t until I participated in art therapy during residential treatment that I started painting again. Once I picked up a brush, I remembered something important: I truly love to paint.
During treatment, I created a small “Blues” painting made up of 108 blue squares, painted in acrylics on canvas board. It reminded me how calming and meaningful the creative process could be.
108 Blues
Since returning home, life has been busy, and I haven’t made much time to pull out the paints. Instead, I have been focusing on my “Little People” drawings. But this weekend, I finally had the time.
I spent several hours finishing the painting that had been waiting for me for so long. This piece consisted of 300 different shades of blue, each painted in two-inch-by-two-inch squares. It took a while, but I finished it.
300 Blues—finished!
And honestly, it felt like a little win.
Recovery is often about small steps forward, and for me, this felt like one of them. Even better, I already have plans for my next painting. I’ll be sure to share it when it’s finished.
More later…
A Setback Does Not Mean Failure
So…If you have been following along, you know that I struggle with mental health. The transition from residential treatment back to home has been difficult and filled with challenges. I am trying, and even though I experience setbacks from time to time, I am still moving forward.
Recovery is not a one-time event. It is not something you accomplish once and then never think about again. Recovery is a daily choice—a daily fight. Some days are easier than others. Some days feel impossible.
There are moments when I feel like I just cannot keep going, when the mountain in front of me feels too steep to climb. Those are the moments when it becomes most important to lean on a support network. Friends, family, therapists, helplines, or anyone willing to sit with you in the hard moments can make a difference.
This weekend, I had a setback.
I am trying to learn from what happened and reflect on where I might have reached out for support or used crisis resources before the urges became overwhelming. I feel guilty and ashamed about what happened, but I also know I need to practice radical acceptance. It happened. I cannot change that. What I can do is try to understand it and move forward.
In that moment, I felt overwhelmed and alone, like I had nowhere to turn. It is a sickening feeling. I know that self-harm is not a healthy solution, but the urge felt incredibly strong. I wanted relief from the intensity of what I was feeling.
Next time—and realistically, there may be a next time—I want to remember that I can ask for help. That is the difficult part: asking. I worry about being seen as weak or “crazy,” even though I know that reaching out is neither of those things.
The truth is, sometimes I just need help.
And maybe part of recovery is learning that asking for help is not weakness—it is courage.
More later…
130 x
So…I have been struggling with self-harm urges since coming home from residential treatment. Until now, I had been able to manage those urges using my DBT skills. But yesterday and today felt different.
I fought them off for as long as I could, but the urges kept returning—stronger each time. I used the skills I have learned: STOP, opposite action, and intense exercise. I did everything I could to stay in control.
In the end, though, I relapsed.
At first, I saw it as a failure. But a friend reminded me that relapse is not failure—it is part of recovery. Healing is rarely a straight path. Sometimes we take a step backward. What matters is recognizing it, learning from it, and turning our focus back toward moving forward.
Recovery means continuing to try, even after difficult days. It means redoubling our efforts, using our skills again, and refusing to give up on ourselves.
What other choice do we have?
National Text Crisis Hotline: text CONNECT to 741741
More Later…
Me 1. Demons 0.
So…I have been struggling lately with urges to self-harm and suicidal ideation. Today, those urges felt especially intense. But this time, I used my skills.
I practiced STOP and opposite action. I followed my safety plan. I distracted myself with a very hot shower and gave myself enough time and space to calm down and regain control of my thoughts.
I had the razor blade in my hand.
And then, something different happened.
I set it down. I backed away. I chose not to make things worse.
To me, this was a major win.
In the past, I probably would have cut—at least a little. But this time, I didn’t. Not at all. That matters. It may not seem like much to someone else, but for me, it feels huge. Progress is not always dramatic; sometimes it looks like putting down the blade and surviving the moment.
Anna, you would be proud.
The hard part is that even though I am getting help, the urges are still there. I am in treatment, and I talk with my therapist at PHP, but it is different from individual therapy. There is only so much support available in those moments when everything feels overwhelming.
And honestly, I don’t always know what to do with these urges. I’m trying. I’m using my skills. I’m reaching for help. But I am still struggling to understand how to live with thoughts that feel so loud.
Still, today reminded me of something important: I can survive an urge. I can pause. I can choose differently. And maybe healing starts there—one hard-earned victory at a time.
More later…
PTSD and WET
So…I am currently attending a trauma Partial Hospitalization Program (PHP) for treatment of PTSD related to events that happened during my childhood and teenage years. It has been a difficult road, but I am trying to do the work of healing.
According to the American Psychological Association, Post-Traumatic Stress Disorder (PTSD) is:
“A disorder that may result when an individual lives through or witnesses an event in which they believe that there is a threat to life or physical integrity and safety and experiences fear, terror, or helplessness.”
PTSD symptoms can include reliving traumatic experiences through painful memories, flashbacks, or nightmares; avoiding reminders of the trauma; feeling emotionally numb or disconnected from others; and living in a constant state of heightened alertness. It can affect sleep, concentration, memory, and even bring feelings of guilt or shame.
For treatment, my program is using something called Written Exposure Therapy (WET). According to the U.S. Department of Veterans Affairs National Center for PTSD, WET is a short-term therapy in which a person writes about their traumatic experiences and the emotions connected to them over the course of five sessions.
The idea behind it is simple, though not easy: many people with PTSD avoid thinking about their trauma because it feels unbearable. Avoidance may help in the short term, but it often keeps the pain alive in the long run. WET works by helping a person gradually face those memories through writing, learning over time that the emotions, while painful, can be tolerated. The hope is that the memories become less overwhelming and less controlling.
I haven’t started the writing portion yet. That begins this week, and if I’m being honest, I’m anxious about it. Writing about trauma feels intimidating. I know there are things I have spent years trying not to think about, and now I am being asked to put them on paper.
At the same time, I’ve been struggling with urges to self-harm. The urges are there, and they are loud some days. But I am using my DBT skills—especially opposite action and STOP—and they are helping. I haven’t acted on the urges. That matters.
This part of healing is hard. Really hard. But I am still here, still fighting, and still trying. I can beat these demons.
More later…
Little People
So…for a while now, I’ve been creating little “Little People” drawings. What started as something simple has become surprisingly meaningful to me. I find drawing them incredibly relaxing, and it has turned into one of my favorite ways to cope when anxiety starts to creep in.
There is something calming about putting pen to paper and focusing on tiny details. It helps slow my mind down, gives me something gentle to focus on, and offers a healthy distraction when things feel overwhelming.
If you’d like to see them, you can find my collection on my Little People page. And if one speaks to you—or if you’d simply like one of your own—please let me know. I’d be happy to send one your way.
Little People Drawings
Anna
Dear Anna,
I could really use a friend like you right now. You’ve been there before, and you understand in a way most people never could. The demons are calling again, and I’m struggling to resist.
You never encouraged me back then, and I admire you for that more than you probably know. But that was another time, and everything feels different now. I’m alone, and they keep whispering my name. I don’t know if I’m strong enough to keep fighting.
There’s something seductive about it, isn’t there? The feeling on my skin, the rivers of color, the strange sense of release. Part of me is afraid I may return there again.
I wish I’d had the chance to say goodbye properly. So if I never hear from you again, goodbye, dear Anna. Goodbye.
Until another time,
David
I told Brittani
I told Brittani that I was okay.
I told Brittani that everything was fine.
I told Brittani that I didn’t need help.
I told Brittani that I could make it through.
I told Brittani that I would be back.
I told Brittani that I was safe.
I told Brittani that I wouldn’t hurt myself.
I told Brittani that everything was out of the house.
I told Brittani that I wouldn’t do it.
I told Brittani that everything is locked up.
I told Brittani that I wouldn’t end it today.
I told Brittani that I can do it alone.
I told Brittani that I wondered if it was worth it.
I told Brittani that I would see her on Monday.
I will, won’t I?
Maybe.
back where I started
So…I am home from residential treatment, and in many ways, it feels like I’ve landed right back at square one. The strange part is that I’ve changed a lot, but home hasn’t. The same stressors, the same environment, and the same pain that sent me to treatment are all still here waiting for me.
I came home with new skills, new insight, and the beginning of healing. I’ve started to work through some incredibly difficult things. But something still feels off, like a piece of me hasn’t caught up yet. Maybe that missing piece is simply learning how to exist outside the safety of treatment.
The adjustment has been harder than I expected. With that, difficulty has come intense anxiety, and when my anxiety gets high, it often brings persistent thoughts of self-harm and suicide along with it. A really terrible combination.
This week, I started a new Partial Hospitalization Program (PHP) focused on trauma. I think it will be a good bridge between residential treatment and outpatient therapy. It gives me structure, support, and a place to continue doing the work. Still, I’ve found myself minimizing how bad things really feel.
On my daily check-in sheets, I note that I’m struggling with these thoughts, and I’ve already had a couple of conversations about safety. The staff means well, and I know they care. But I’m terrified that if I fully tell the truth about how often these thoughts show up, I’ll be sent right back to inpatient or residential treatment. So I soften it. I downplay it. I say enough to be honest, but not enough to feel dangerous.
At home, we’ve taken steps to keep me safe. My medications are locked up, and there are no sharps in the house. But today I had to pick up a prescription refill from the pharmacy: a bottle with 130 pills in it.
I sat there staring at that bottle for an hour.
Part of me wanted to take them, and admitting that fills me with shame and guilt. But I didn’t do it. Somewhere inside all the noise and fear and pain, there was still a small part of me fighting to stay. Right now, that small part feels worth holding onto.
More later…
Links-a-go-go
Here are some helpful links and phone numbers:
988 - National Suicide Lifeline
www.988lifeline.org911 - Emergency
1.800.Don’t.Cut - Self-harm Support Hotline
1.800.SUICIDE - hotline for people contemplating suicide
1.800.334.HELP - Self-injury Foundation’s 24-hour crisis line
1.866.488.7386 - The Trevor Project LGBTQIA+
www.thetrevorproject.orgwww.findahelpline.com - Find a helpline
Maladaptive Schemas Quiz - The Attachment Project
www.linehaninstitute.org - The Linehan Institute (DBT)
https://dialecticalbehaviortherapy.com Dialectical Behavior Therapy (DBT)
What is Cognitive Behavior Therapy - Mayo Clinic PDF
Cognitive Behavior Therapy - Mayo Clinic
Cognitive Behavior Therapy - American Psychological Association
Cognitive Behavioral Therapy - American Psychological Association PDF
Borderline Personality Disorder - Mayo Clinic
Borderline Personality Disorder - National Institute of Mental Health
The Great Dialectic
At the heart of Dialectical Behavior Therapy (DBT) is a simple but transformative idea: the word “and.” It’s a small word, but it holds immense power. “And” allows two truths to exist at the same time. It doesn’t erase, minimize, or replace one feeling with another—it makes room for both. In that space, healing can begin.
For me, this concept has been life-changing.
When I was 13, I experienced sexual assault. The impact of that moment didn’t stay in the past—it followed me, shaping years of depression, anxiety, and internal struggle. For a long time, my experiences felt all-consuming, as if there was only room for pain.
But through treatment, I’ve begun to understand the power of “and.”
I can acknowledge what happened to me and recognize that I am still here.
I can feel pain and allow moments of peace.
I can carry my past and move toward healing.
This idea—this dialectic—has given me something I didn’t have before: permission to be okay, even while holding difficult truths. It doesn’t erase what I’ve been through, but it changes how I live with it.
“And” didn’t fix everything. But it gave me a way forward.
It was not my fault and I sometimes still feel guilty.
I did the best I could in that moment and I wish things had been different.
I did not deserve what happened and I am still carrying the impact of it.
I am not to blame and I am allowed to feel anger about what happened.
Someone else made harmful choices and I am the one doing the healing work.
I survived the situation and I didn’t deserve to have to survive it.
I feel strong and I feel deeply hurt.
I feel angry and I feel sad.
I feel numb sometimes and I also feel overwhelmed at times.
I feel shame and I know the shame does not belong to me.
I want to forget and I want to be understood.
I feel broken sometimes and I am still whole as a person.
I feel scared and I am learning ways to feel safe again.
I lost control in that moment and I am regaining control now.
I felt powerless then and I am building strength now.
My body remembers the fear and my body can also learn safety again.
I feel unsafe sometimes and I am learning how to protect myself now.
I was vulnerable and I am resilient.
What happened hurt me and it does not define who I am.
Healing is hard and I am capable of doing hard things.
I am still affected and I am making progress.
Some days feel heavy and I keep moving forward anyway.
I am healing slowly and slow healing is still healing.
I am allowed to struggle and I am allowed to grow.
I can carry pain and still create meaning in my life.
I feel afraid to trust and I want connection.
I feel guarded and I still care deeply about others.
I was hurt by someone and not everyone will hurt me.
I feel distant sometimes and I am capable of closeness.
My body was hurt or violated and my body still belongs to me.
I feel disconnected from my body sometimes and I am learning to reconnect.
I feel shame about my body and my body deserves care and kindness.
I feel uncomfortable in my body and I can learn to feel safe in it again.
I feel weak sometimes and surviving took strength.
I judge myself harshly and I am learning to be compassionate with myself.
I feel damaged and I am worthy of love and respect.
I feel alone at times and I am not alone in my healing journey.
I struggle and I am still worthy.
The past cannot be changed and my future is still mine to shape.
I carry memories and I am not trapped in them.
I feel afraid of the future and I am taking steps forward anyway.
I have been hurt and I can still build a meaningful life.
More Later…
On my way
So…There’s something surreal about leaving a place that has held you together for weeks.
Today, I’m on my way home. I left the treatment facility at noon and now I’m sitting at the train station, waiting for the next leg of the journey. It feels like a transition in every sense of the word—not just physically, but emotionally too. I’m carrying a lot with me as I leave: gratitude, uncertainty, pride, and, if I’m being honest, a bit of fear.
I have mixed feelings about going. On one hand, I’m genuinely excited to be home, to step back into my life and reconnect with the world outside of treatment. On the other hand, it’s hard to leave behind a place that has been so safe and supportive. The people I met here—especially the other residents—became an important part of my daily life. There’s something uniquely powerful about going through something difficult alongside others who truly understand. I’ll miss that more than I can easily put into words.
But this isn’t the end of the work—it’s just the next phase. I’m moving into a trauma-focused partial hospitalization program, and I know there’s still a lot ahead of me. That’s both intimidating and grounding. It reminds me that healing isn’t a single moment or a finished milestone—it’s a process that unfolds over time.
More than anything, I want to take a moment to say thank you. To the people who supported me throughout this experience: you showed up for me in ways that mattered deeply. I leaned on you—sometimes heavily—and you met me with care, patience, and consistency. That kind of support is not something I take lightly. It made a difference in ways I’ll carry with me long after today.
I wouldn’t be where I am right now without that support. And while I’m stepping forward into something new, I’m doing so with a stronger foundation than I had before.
So here I am—somewhere between where I’ve been and where I’m going next. Waiting for a train, yes—but also, in a way, learning how to move forward. More later…
Almost
So…I have about a day and a half left at this residential treatment facility. It’s hard to believe that after two months here, I’m almost at the finish line. During this time, I’ve learned so much about myself and developed a toolbox full of DBT skills that I know will continue to help me long after I leave.
Even with all of that growth, I feel a little nervous about going home. Here, I’ve had support and care around the clock. The environment has been intentionally safe—no sharps, constant supervision, and people available whenever I needed help. That level of safety has allowed me to focus on healing, learning, and practicing new ways to cope.
Lately, though, as my discharge date gets closer, I’ve noticed my anxiety increasing—and with it, my urges. I’m doing everything I can to resist those thoughts and not give in to them. It feels like the closer I get to leaving, the louder those internal struggles try to become.
Another patient and I were talking about this recently. She shared something that stuck with me: when you’re almost out, the demons try to claw you back harder than ever. It’s a powerful image, and in many ways, it feels true. This final stretch isn’t just about waiting to leave—it’s about being resilient and staying committed to the progress I’ve made.
I’m leaning heavily on the skills I’ve learned here. I know these thoughts and urges may not disappear entirely, but they don’t have to control me. I can keep them at bay. I can sit with discomfort, use my coping strategies, and remind myself that I am stronger than the urges that try to pull me backward.
This last day and a half feels both exciting and intimidating. It marks the end of one chapter and the beginning of another—one where I take everything I’ve learned and apply it in the real world. That thought is scary, but it’s also empowering.
More later…
A day helps
So…I have been struggling with anxiety due to changes in my medical insurance. When I first learned about the change, my mind immediately went to worst-case scenarios. That’s a pattern I know well—my brain tends to assume catastrophe before I have all the facts.
I’ve now had a day to sit with the anxiety and think more clearly about how this is going to work. The reality is that I have been fortunate. My insurance has helped pay for my stay at this residential treatment facility, which I am incredibly grateful for. It’s also important to remember that I am not losing insurance coverage altogether. I simply need to complete the COBRA paperwork and pay the premium to continue my coverage.
Even knowing this, the anxiety and worry still show up. That catastrophic thinking creates a lot of stress, and it’s something I recognize as an area I need to keep working on. This is another opportunity to practice the skills I’ve been learning—pausing, looking at the facts, and reminding myself that not every problem is a disaster.
More later…
5 days to go
So…I have five days left in my treatment program. I’ve learned a lot and made significant progress. However, I found out yesterday that unexpected things can still throw me off balance.
I learned that my health insurance will end at the end of this month, and I will need to apply for COBRA coverage. This will reset my insurance, and I will have to pay my $1,500 deductible again. This situation has caused a lot of anxiety.
I am scheduled to start my next program on Tuesday, May 5, 2026, but I’m not sure how that will work. My COBRA insurance will be retroactive to May 1, 2026, but I won’t have paperwork to prove coverage right away. I don’t know if they will allow me to start the program without proof of insurance, or if I will have to wait until I receive the actual insurance card.
This entire medical leave process has been stressful and confusing. It feels like nobody has clear answers, and I’m left in the dark wondering how I will pay my bills. I applied for the Minnesota Paid Leave program and for long-term disability. My Minnesota Paid Leave benefits were approved, but HR says the leave dates may be incorrect, and I might have to repay some of the benefits. My long-term disability was supposed to begin on March 27, 2026, but they are still determining whether I qualify.
It all feels very overwhelming and makes my anxiety worse. I am in a depression and anxiety treatment program and trying to focus on my recovery, but these issues make that very difficult. I’m doing my best to sit with the anxiety and breathe through it, but it keeps building.
More later…