How I stop the sh*t from hitting the fan (a.k.a) relapse prevention.

Relapse. Feels like a dirty word. A personal failure that happens when you thought you had your shit together. Statistically, it’s more likely than not that you will relapse at some point in time.  Depressing thought but all is not lost, here’s a little more about how I stop the shit from hitting the fan.

 

Use a (free) sleep and mood tracker:  There are many free trackers for logging mood and sleep patterns. Stepping on sleep problems early (for example being strict with bed times, using a short course of sleep medication as recommended by your doctor) can avert a full blown crisis. Secondly, having information about thoughts and feelings leading up to mood changes can help identify subtle negative thought patterns which can be challenged using techniques such as cognitive behavioural therapy to reduce their impact on mood.

 

I know my triggers: Extreme stress, too much alcohol, poor sleep. Day to day I cope with stressful events pretty well. We all have stress in our lives and living completely stress free can potentially hamper our creativity (anyone who has waited until a few days before an important deadline to start a project will know what I mean). I’m talking about major stressors. I can trace pretty much all of my depressive episodes back to specific life events (giving birth, a 2 week bout of being in bed with flu, grief). As for alcohol, if I have a few nights of 2 or 3 drinks each night it makes me depressed and anxious. Even at Christmas I try to moderate my alcohol intake as much as possible as the fun never seems to be worth the drop that happens afterwards.

 

Use healthy coping mechanisms: When you know what your triggers are you can utilise positive coping mechanisms to balance them out. I like to exercise, especially when I’m stressed. Out goes the negative energy and in come happy chemicals**. I also like to knit (the focus of making sure I don’t mess it up takes my mind off everything else), keep a journal and read. Find something you enjoy and deploy it often!

**This has backfired once during the early phase of a hypomanic episode. I did my usual zumba class and stayed awake until 1am that night. Lights, latin music and jumping around are not good for the overstimulated mind.

 

Accept that not every bad day or different emotion means that a relapse is going to happen: If you have kids, do you remember when they were born and you were obsessed with their toilet habits? Have they pooped today? What colour was it? What does green poo mean anyway? If they haven’t pooped should we talk to the doctor Before you had kids did you give any thought to other peoples bowel habits? Probably not. This is my way of saying that when we focus on one small thing we can become bogged down and miss the bigger picture. When I’ve one bad day (tired, hormonal, bad day at work), I often decide a relapse is coming. I’m on that downward spiral, I haven’t noticed and there’s nothing I can do. Then I wake up the next day, laugh that I had a bit of a shitty day yesterday and go about my business. One bad day does not make a relapse. Feeling elated because you had a great time with your family at the weekend does not mean hypomania is coming. Recognising and accepting the contrast between different thoughts and feelings can be hard if you’re prone to over-analysing but it’s important to know that everyone (regardless of mental illness) goes through a spectrum of emotions.

 

If the shit does hit the fan, remember that you’ve done this before. You can handle this. You can follow your plan to the letter but there’s no foolproof way of avoiding relapse.  It’s going to take some time and effort but you can and will get through. Scale down your expectations, if showering and brushing your teeth is the only goal you can achieve then that’s okay. Lean on your support network and be kind to yourself. Slowly and steadily things will be rebuilt.

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The Unwanted Christmas Gift

No, it’s not socks, you’re going to have to read on.

Here I was, sitting in a small consultation room whilst the psych took notes. It had taken 4 months just to get this “emergency” appointment and like many much-anticipated events there was relief that finally it was happening.

The psych eyed me from her chair, a petite woman who spoke calmly and quietly. She seemed nice. Still, I was terrified of her. I hadn’t actually met her before today’s appointment which added to my awkwardness. Thankfully, she “had already read all the notes” sparing me some of the gory details.

I only had two questions: what is wrong with me? how are we going to fix it?

“You have bipolar disorder.” It wasn’t unexpected but I still burst into tears. It had taken a year to get this diagnosis, lots of watching and waiting for me to become ill again so the psych team could see my symptoms first hand and decide what the hell was wrong with me.

It was a chain of out of character behaviours and events that led to bipolar first being mentioned. I’d felt like I was “flying”, over my depression and making up for lost time. Yeah I got over excited at times but thought of it as a good spell away from the crushing lows of a major depressive episode.

My husband would say I was “on one” when the early exercise sessions, overcommitting myself at work, not eating and sleeping for only a couple of hours at night happened. I’d spend more than usual (including buying a box of Emma Bridgewater mugs in what may be the most middle-class hypo manic episode ever), be louder, drink more and flirt more than usual (my normal social anxiety would be replaced with a ride or die party girl). Hypomanic me was fun. More confident, more creative, more productive than ordinary me.

Of course, there was a flip side. I’d burn myself out to the point of exhaustion then end up in bed for a week after pushing myself to the limit mentally and physically. The first hypomanic week felt great but as it rolled on I’d get anxious, paranoid and demanding, afraid of my excess energy and that I would end up doing something stupid like buying the Mercedes I’d been eyeing up for ages. For the most part, I was able to curb my behaviour at times, surrendering my credit cards to my long-suffering hubby and taking the pills the GP prescribed to make sure I got a few hours of rest at night. During the times I couldn’t curb my behaviour, the feelings of shame and guilt about my actions and behaviours added to the inevitable low after the fall, fuelling a negative cycle of hate and depression.

What a shitty Christmas gift I thought. Although we knew what it was, it wasn’t so easy to decide what we were going to do about it. The goal (apparently), is to avoid hypomania for as long as possible. The more episodes of hypomania, the worse the prognosis that things could progress to a full blown manic episode. Right now, I think bipolar could be the gift that keeps on giving and not necessarily in a good way.

Happy World Mental Health Day (and a rant about mental health in the workplace)

Happy World Mental Health Day 2017. I’m slightly grumpy as I wrote a nice long post then my internet broke, also I’m still receiving random parcels following a hypomanic episode last week which almost certainly means a very large credit card bill! Seriously, WTF did I even order?!

 

Anyway, moving swiftly on, the theme for World Mental Health Day 2017 is mental health in the workplace. A sensible choice given that $1 trillion is lost every year from the economy due to mental illness. I’ve been on the receiving end of some pretty poor treatment at work due to my mental health (ex-manager who told me I just “needed to pull myself out of it”, I’m looking at you).  I’ve also had some wonderful employers and colleagues who’ve done kind things like invite me in for coffee (just so I don’t feel excluded from the team, no work related chat allowed), sent me cards and helped me with a gradual return to work rather than going all in and risking relapse.

 

Working full time in a demanding job isn’t always great for my mental health and there’s certainly frustration on my part that I can’t put in as many hours as my colleagues (I try to take a lunch break each day- even just 10 minutes and try and leave work within 20 minutes of my official finish time). Yes there are times when I go home and straight to bed, or avoid opening my emails because anxiety girl decides there is bound to be a message from my boss telling me I messed something up/forgot to attend a meeting/am fired, despite no evidence of any of these things!

 

Like physical illness, mental illness reduces my resilience so I have to take it easy to avoid the merry go round of getting better vs. burning out again. For me, work by far outweighs staying at home, I need the human interaction, I need to challenge my brain, I need the structure of being somewhere for 9 hours a day otherwise I’d get lost in a sea of spending my days in pyjamas and probably drinking endless cups of tea (who am I kidding, I DO drink endless cups of tea).

 

One thing is for sure, opening up to my colleagues about my mental health problems has largely been a positive experience. Sometimes people will tell me their own experiences, or offer me words of support. What helps most for me is when people ask me how they should respond to my mental health issues rather than avoiding the subject during conversation. It lets me joke about it (not always politically correct but I don’t mind calling myself crazy, the problem is when words are used with a negative implication), or when someone asks if I’m tired, allowing me to own up and say “Yeah, shit nights sleep as my anxiety is bad” makes a huge different because putting up a front is tough work.

 

So here’s to happy, fulfilled, healthy work! Keep talking and take care of each other.