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.

5-things to do when you’re struggling with your mental health

Having hit rock bottom (with a splat) several times in my life, I’ve built up an awareness of what does and doesn’t help my symptoms.  Now, before I share this list, I’m want to say: this stuff isn’t rocket science but in the middle of a mental health crisis getting out of bed is hard, let alone anything else. It’s also easy to dismiss small changes and activities that stuff that psychs/nurses/relatives tell us will help.

During one particularly bad call to my crisis team I remember being told to slow down and start breathing deeply. I wanted to scream down the phone:”Breathe?! WTF do you mean breathe?! Of course I’m bl**dy well breathing, I’d be dead if I wasn’t. I’m calling you because I feel like I want to die and the best advice you can give me is breathe?!”

As it was, I did the breathing exercise like I was told and after a couple of attempts felt much better. I still remember the name of the nurse who took my call, her nagging me to breathe made a world of difference. I’m not going to say if you get your breathing right your mental health problems will vanish, we all know it’s not like that.

So without further rambling, I give to you my list of 5 things to do when you’re struggling with your mental health:

1. Write it down: I’ve journaled for about 15 years now, my journal provides a safe space for me to vent but it also helps me track my mood and look for patterns in my behaviour. It also means I get to splurge on stationary (particularly stuff that’s shiny….I love shiny!). If you’re struggling to open up to loved ones or professionals about your feelings, show them your journal instead.

 

2. Exercise (at the right time and with the right type of activity): I do not enjoy sweating. I don’t like lycra. You won’t find me in the gym. BUT I love how I feel when those happy chemicals are floating around after an hour of dancing. There’s plenty of research about the benefits of exercise to help regulate our sleep patterns, reduce our stress and increase our energy levels. The key is finding what works for you, I don’t run anywhere but I love yoga and cycling. On the days that feels like too much, a 20 minute walk is enough to give me a boost. A word of caution- time your exercise well, during a particularly highly strung phase, my evening exercise class gave me such a buzz I was awake until well after 1am. The Royal College of Psychiatrists have a nice leaflet about exercise and its’ impact on mental health here.

 

3. Avoid excess alcohol: Yep you feel more relaxed after that first drink. Maybe you’re drinking a few drinks to get you off to sleep each night. But remember: alcohol is a depressant. It wipes out that happy chemical serotonin (which is also the chemical many antidepressants work on). So not only are you making yourself more depressed, you’re also making it more likely that your antidepressants won’t have the full effect. Drinking to excess also puts you at risk of making poor judgements calls by decreasing your inhibitions.

 

4. Use technology to help, not hinder your recovery.  I love the internet. I love being able to research, read the news and access support groups at the same time as stalking people I know on social media. I also like to go on pinterest and make boards about tattoos I will never have the guts to get and recipes I will never actually make. Social media can bring out the worst in us: never ending comparisons about people we haven’t seen since school (Wow, she looks so happy, her family are gorgeous, I’m so jealous of that car etc) or reading too much into situations (two of my friends went for coffee?! Why wasn’t I invited?! I’ve obviously upset them and they don’t want to be friends with me.)  Lets not forget the sleep destroying effects of blue light emitted from phones and tablets. At its’ worst tech leaves us overstimulated and anxious. Can’t take a break? Force yourself to let a loved one change your passwords for a week- the temptation is gone. Or make a firm decision to put the tech down an hour before bed so that blue light doesn’t impact on your sleep.

 

5. Do something to occupy your mind. Distraction is a useful tool and yet one that we struggle to use. When I’m low, an hour can feel like a week and I don’t always see the value of doing something to take my mind off things, I’d rather sit in my pyjamas and stare into space. Do something to take your mind off things: read a book, do some colouring in (I’ve got a swear word colouring book that I love, intricately colouring the worse Asshole with pencils always amuses me), walk, knit, paint your nails, do some puzzles, download a free mindfulness app and try one of the exercises. Even if you set a timer and do it for 10 minutes, just DO it. You’ll feel proud that you have and often when the timer goes off you’ll carry on with your activity. I love to read but when I’m a bit manic I can’t focus on the words so instead I like to bake cakes. When I’m down I watch Youtube videos of baby animals, also a good way of keeping little people amused if you have them.

 

What small things do you do to help look after yourself when you’re struggling with your mental health? What baby animals would you watch on YouTube (panda’s are my fave). Let me know by commenting or e-mail. Pictures of sparkly stationary are always welcome too!