My Experience Only. YMMV.

Posts tagged ‘anxiety’

Realistic Self-Care

woman in white long sleeved shirt holding white ceramic mug

Photo by bruce mars on Pexels.com

I hate articles about self-care for mental illness such as the one I saw recently that said:

…[W]ays I practice self-care include swimming and Pilates, getting regular massages, spending time with friends and family, since staying connected is an essential part of emotional health at every age, watching TV, and seeing movies. I also love going for walks, especially near Santa Monica beach, and reading or listening to books.

If I could do all those things, I wouldn’t need self-care! When I’m depressed or anxious, I cannot make myself swim or exercise, or even get out of bed and shower at times, which lets out going to the movies and spending time with friends, too. I can maybe read a book or listen to a podcast if I’m not too twitchy and if my attention span and concentration will cooperate. And I can sit on the sofa and watch TV, but that feels like uselessness, not self-care.

Plus, guess what? A lot of those activities cost money.  Massages, movies, exercise classes (for which you need exercise clothes), and swimming (for which you need a swimsuit) would all require “shopping therapy,” which I loathe IRL and can’t afford online.

I personally would love a massage, but that’s not self-care for everyone. As Emily Roberts points out in “Self-Care for Mental Health: Find Ways That Work for You”:

The myth of a massage as an essential self-care activity – or anything that makes you more anxious – isn’t helpful for your mental health. I didn’t listen to my body the first time I booked a massage and guess what? It was so triggering to my body I couldn’t even finish it….I started to cry and couldn’t compose myself 10 minutes into the appointment. I was embarrassed and confused. I thought, “This stuff works for all the people in the magazines. What is wrong with me?”

I decided that booking an extra appointment with my therapist and having a date with my best friend was more helpful as self-care for my mental health than pushing myself to practice self-care in the way the media was telling me to.

One person’s mani-pedi can be another’s nightmare. I much prefer small ideas for self-care rather than big expeditions or splurges. For me, comfort food is one form of self-care. It has to be something I can make easily, though, like frozen mashed potatoes, mac-n-cheese, or French bread pizzas. (The microwave is my friend.)

Of course, these comforts require a little planning when I’m not overwhelmed to the point that I need self-care to restore me. I must think ahead, during those times when I’m able to go to the store, to bring home the foods that are easy to make yet soothing.

Another self-care technique I came across is definitely more my speed. Caiti Gearsbeck, in “Make Your Own Mental Health Self Care Kit” offers a simple, DIY alternative. She recommends filling a shoebox or other box with soothing things that appeal to all five senses, plus a few activities. Here are a few of her examples:

Sight: photos, cards, and letters

Smell: essential oils or candles

Taste: chocolate or tea

Sound: meditation CD or an mp3 player with a playlist

Touch: soft cloth or stuffed animal, stress ball or fidget cube

Activities: coloring books and pencils, a journal, a favorite movie

She adds: Whatever works for you!

For me, that box would contain photos, Irish Spring soap, oolong tea, an mp3 player, a stuffed animal (I have lots to choose from), and a CD of The Mikado. I’d need a cat in the box, too. But given the nature of cats, there would probably be one in there anyway, whether I wanted it or not. All of that is stuff I have around the house, unless I’m out of Irish Spring or oolong. Add a quiet room like the bedroom or my study and I’m all set. At least until I can afford a massage.

 

References

https://blogs.psychcentral.com/millennial/2017/10/make-your-own-mental-health-self-care-kit/

https://www.jwi.org/articles/mental-health-and-self-care

https://www.healthyplace.com/blogs/buildingselfesteem/2018/5/self-care-for-mental-health-find-ways-that-work-for-you

On Pain and/or Suffering

Recently, when I was reading Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis by Lisa Sanders, I came across this:

Eric Cassell, a physician who writes frequently about the moral dimensions of medicine, argues, in a now classic paper, that pain and suffering are very different. Pain, according to Cassell, is an affliction of the body. Suffering is an affliction of the self. Suffering, writes Cassell, is a specific state of distress that occurs when the intactness or integrity of the person is threatened or disrupted.

Later, when I was reading M Is for Malice, by Sue Grafton, I read this: “Pain was better than anxiety any day of the week and sweat was better than depression.”

The universe seemed to be telling me to focus my attention on pain and/or suffering.

Cassell (as quoted by Sanders), could have been (but probably wasn’t) talking about bipolar disorder when he defined suffering as “a specific state of distress that occurs when the intactness or integrity of the person is threatened or disrupted.” I certainly don’t feel intact or integrated while in the midst of a bipolar episode – either hypomanic or depressive. I suffer. My personhood is certainly threatened and disrupted.

It’s common to hear bipolar described this way: “I suffer from bipolar disorder.” I prefer to say “I live with bipolar disorder,” which I feel is more accurate. It’s always there, but I’m not always suffering. I live with it and it lives with me.

I think Cassell was wrong, though, about pain being a purely bodily sensation. I addressed the concept back in the early days of this blog. with a post called “Depression Hurts” (https://wp.me/p4e9Hv-6Z). In it I claimed that bipolar (or depression specifically) caused physical pain as well as emotional pain. I still maintain that one is as valid as the other and that they are virtually inseparable. The mind and the body not being entirely separate, or separable, you see. You get both for the price of one.

Grafton, on the other hand, through her character Kinsey Millhone, was talking about the physical act of running. We all know by now (or should) that exercise is recommended for those who have bipolar disorder or other mental/emotional conditions. But again, there is this idea that physical discomforts (pain and sweat) are better than emotional distress (anxiety and depression). She seems to be saying that pain is the antidote for suffering.

This can be dangerous territory. As someone who used to self-harm, I can easily see how one might think that pain is preferable to anxiety, or numbness, or dissociation – to suffering, that is. But in such cases, pain is really just another aspect of suffering, expressed in bodily terms. Again, the two are inextricably intertwined.

Personally, I would be delighted to avoid all four sensations – pain, anxiety, sweat, and depression. But I don’t think that’s possible, even with avoiding both exercise and self-harm. Sweat is the easiest to dispense with, thanks to modern toiletries, but there have been plenty of times when my anxiety has caused me to sweat. Think about being summoned to a tax audit, for instance, and you’ll see what I mean. Pain is unavoidable; no one goes through life without stepping on a nail or some such. Anxiety and depression occur at least occasionally in the neurotypical as well as the mentally disordered.

The human condition itself involves feeling both pain and suffering. Bipolar disorder involves both pain and suffering. Well, what do you know? We’re only human, after all.

Knitting Away Depression and Anxiety

Photo by Athena, Creative Commons

Last week I dissed a story that I read online about self-care for bipolar disorder, which consisted of praise for sleep, pets, and creativity, things which anyone with bipolar already knows are good for their mental health.

It was pointed out to me by someone who should know that I was wrong to make fun of the researchers, since they were students learning valuable lessons about how to conduct research studies in the first place. Which led me to believe that it was all the reporter’s fault for presenting their results as news.

Anyway, as an apology to researchers and grad students everywhere, I’m now going to praise a research study that would otherwise get a “well, duh” from me.

Huffington Post (UK) shared the good news:

Knitting could save the NHS [National Health Service] vital funds because it leads to a healthier population, reducing depression and anxiety, slowing the onset of dementia and distracting from chronic pain, a new report has found.

The study was primarily focused on the benefits of knitting for the aging, but since depression and anxiety were two of the conditions that it reportedly relieves, I thought it might be relevant to bipolar disorder too. Now someone can do a study to confirm or deny this idea.

The report added that knitting “is a sociable activity that helps overcome isolation and loneliness, too often a feature of old age,” and, I might note, of mental illness.

There are many, many articles that extol the benefits of creative pursuits for those with bipolar disorder and other mental illnesses. Although the notion of “basket-weaving” is outmoded and stigmatizing, other creative activities are commonly suggested as part of self-care. (I discussed this in a post called “Tools for Tackling Bipolar Disorder.”)

Coloring seems to be the most popular recent trend, but drawing, painting, collages, and all sorts of needlework are well thought of too. (I would certainly put crocheting in the same category as knitting.)

But then there’s the other side of bipolar – mania. I don’t know a lot about creativity and mania because I only get hypomania. But I do know that when I’m hypomanic I can get a lot of writing done. (Whether it’s good writing is another question.)

However, if you’ll forgive anecdotal evidence, I once knew a woman who did experience full-blown mania as part of her disorder and was not well controlled on medication. One year at Christmas she decided to make green velvet dresses for all three of her daughters.

As she spoke of her progress over the ensuing weeks, however, it was clear that the project was not going well. She kept rethinking – and redoing – all the sewing. She didn’t like the design, or she didn’t think they’d fit right, or she saw some other flaw. She never finished the dresses.

Other people may have better experiences with mania and creativity, of course. I hope you’ll share with me if you have.

The idea of creativity as a way to be sociable intrigues me. Sewing circles are a time-honored tradition among neurotypical people as well as those with mental disorders. (A friend of mine and her cronies had what they called the “Stitch and Bitch Club.”) Needlepoint, quilting, and indeed all of the fabric arts can be group activities.

For those who aren’t into those kinds of needle-centric activities, there are classes in scrapbooking, drawing, painting, ceramics, sculpture, or other creative art forms, often available through local adult education programs, museums, or shops that sell arts and crafts supplies. And of course, writers’ groups abound at bookstores and other venues (though presenting one’s own work at such a gathering may be too daunting for some with self-esteem issues).

I should probably get involved with a writer’s group myself. I’ve had to give up needlework because of my eyesight and shaking hands. But I’m all for doing something for my brain. Lord knows, it needs all the help it can get.

 

References:

http://www.huffingtonpost.co.uk/entry/knitting-linked-to-health-benefits-including-reducing-depression-and-slowing-dementia-report-reveals_uk_5aa63cb0e4b07047bec7feee?ncid=tweetlnkukhpmg00000001

knitforpeace.org.uk

“Tools for Tackling Bipolar Disorder” https://wp.me/p4e9Hv-uT

 

Bipolar Me, Looking for Work

I have been very fortunate over the last few years in that I have been able to work and that, combined with my husband’s far-from-large – but steady – paycheck, we have been able to pay the bills. Now that seems to be changing.

After my last big emotional crash, I was unable to work at all, and after my husband’s major burnout, he was not able to work for a while. We ran through our IRAs and ended up in the situation where we are now.

I do writing, editing, and proofreading jobs from my home computer. It is really ideal, in that the projects usually come sporadically, with time in between them, so I seldom require more energy than I have available. I do not have to go out very much, or dress up very often and can work in my comfort zone, in my comfortable study, in my comfy pajamas. In these respects I am lucky or blessed, or however you wish to define it.

But clients have become a little thin on the ground lately. And I am afraid. I fear both a financial crash and an emotional one. The two are not unrelated. Finances and dealing with them were two of the largest triggers that started the major depression-plus-anxiety that swallowed me up for quite a few years.

Now I am feeling the pinch again. I felt it back in August, when my “proactive hypomania” helped me get through (https://wp.me/p4e9Hv-y4). But one can do that only so many times. Or at least I can’t summon the necessary mood at will. (Surprise, surprise.)

I have a writing project now, but it will run out in January. I have another client, but work from them is not as consistent as it used to be. We are already behind on some of our bills, including the mortgage.

So I am looking for more work, and it is scary.

The kind of work I’ve been doing is ideal, even when my symptoms increase. It lets me work around the deficits that bipolar heaps upon me. If I have a project due Monday, I can work during the weekend. If I have insomnia, I can work at night. If I am immobilized, I can usually schedule my deadlines so they don’t all hit at once.

I try to network, also at home from my computer, but that lets out job fairs and professional organizations and groups inhabited by people. I should put together a resume and sample packet and then try to figure out whom to send it to. Which is kind of like throwing spaghetti at the wall and seeing if any of it sticks. And the impressive kind of packet – slick, personalized, colorful, foil stamped, business-carded, sample-stuffed, stationeried – costs money to prepare, which of course is itself a problem since you have to spend it before you get results, if any.

So I have signed up with a number of sites that provide leads on jobs, and some of them don’t even want me to drive for Uber or move to Massachusetts.

Each time I apply, I ask myself, “Can I really do this job?”

Sometimes the answer is “Probably not, but I’m going to apply anyway.” Those are the 9-to-5 office jobs that would require me to upgrade my wardrobe just the teensiest little bit and try to keep the depressive phases under control if not totally under wraps. I have serious doubts about my ability to be “on” for eight hours a day, five days a week.

The Americans With Disabilities Act says that certain categories of people are entitled to “reasonable accommodations” in order to fulfill their job requirements. For someone like me, accommodations might include flextime, doing part of my work at home, time off for doctor appointments, and the like. If I got one of those jobs, I would have to reveal my mental disorder in order to receive accommodations, and I would have to decide whether to speak up about it before or after I got the job. Probably after.

The not-quite-as-frightening jobs are part-time ones, like working the circulation desk at the local library. They have their drawbacks too, including the same ones as full-time jobs, with less pay besides. Would it provide enough income to make a difference? Maybe not. Would I be able to do a part-time job and still squeeze in a little freelance work? I just don’t know. The idea is still daunting, to say the least.

(Another potential solution would be for my husband to get a better-paying job, but he is in the process of changing his meds, so that doesn’t seem likely either, at least for now.)

I know this seems like a better class of problem than many people with bipolar disorder have. Trying to keep up the mortgage payments is better than living under the Third St. bridge, fighting stray dogs for cold french fries. My husband’s job may be low-paying, but at least it’s steady and has a health insurance plan. I am truly grateful for these things.

And I am truly scared nonetheless. And tired. And sliding back down into depression.

Ten Opinions That May Offend Someone

Recently I noticed that I have been reluctant to offend people, particularly on Facebook. I keep my opinions to myself, especially on social and political matters, and dread being “unfriended” or starting (or continuing) a “flame war.”

This is not just a matter that relates to my bipolar disorder, though it is certainly that too. I have written a number of times about how having bipolar disorder and the behaviors it has brought out in me have cost me friends, even ones that I thought were “forever-friends.” These losses have affected me greatly, at times pushing my anxiety and depression buttons nearly as far as they can go.

Just as I have toned down my comments on subjects such as liberal vs. conservative issues, I have also let pass by posts in bipolar support groups and mental health memes on people’s general Facebook timelines that I’ve disagreed with. Oh, when I see a particularly incorrect or egregiously stigmatizing remark, I’ve been known to smack the person on the nose with a rolled-up newspaper, but often in a soft, “In my experience, you may not be correct” manner.

There are also conflicts within the bipolar world that I have strong opinions about but have not jumped into, for fear of offending someone. And I have to ask myself, what would be the consequences of offending someone in such a discussion?

Yes, I might be unfriended. More likely I would be ignored. Or (virtually) yelled at. In other words, if I offend someone with my opinions, they may in turn offend me with their opinions. And while that’s not a productive state of affairs, it’s hardly the end of the world. In an ideal world, I might cause someone to question or consider or engage in fruitful discussion. Not likely, but possible.

So, if I am trying to overcome my fear of offending people with my positions on guns, abortion, health care, climate change and the like, what am I to do about my opinions regarding bipolar disorder and mental health in general?

Well, first of all, I can state where I’m coming from: straight, white, female, married, childless, bipolar type 2, 60 years old, diagnosed for years and on any number of medications for years as well. Not much controversial there. That’s just facts about me and hard to deny.

But here are some things I believe that I know are sometimes subject to differences of opinion. And for what it’s worth, here’s my take on them.

  1. Psychotropic medications are good things. Yes, they can be overprescribed or improperly prescribed, but when dispensed and used correctly, they help.
  2. The Scientologists are way off base. Mental illness exists, and so do treatments for it.
  3. “Natural” or “holistic” treatments for mental illness are not enough to replace medication and talk therapy.
  4. Sunshine, exercise, and positive affirmations are good things, but also are not enough to replace medication and talk therapy. They do good for a number of people, less for others, and not much at all for some.
  5. We’ve got to change the popular dialogue about mental illness and violence. We must not let it go unchallenged. For that matter, we must change the popular dialogue about mental health in general.
  6. While it’s a good thing if those with mental illness take their medications properly, it is absolutely their right to refuse treatment.
  7. Health care (and insurance plans) should cover mental health care at the same levels as physical health. (Okay, that one’s not really controversial among the mental health community.)
  8. Emergency responders including police should all receive training in dealing with mental health issues, but they probably won’t.
  9. Most people don’t/won’t/can’t understand mental illness until it touches their own life in some way, and maybe not even then.
  10. Education about mental health issues should begin in grade school.

There. If you disagree with any of those statements or feel that I am an idiot for stating them, so be it.

Oh, and while we’re at it, persons with a mental health diagnosis should not automatically be prevented from owning guns, but people with domestic violence convictions should be.

From Panic to Manic to Proactive

Hypomania isn’t all bad. Right now I’m facing one of my worst triggers, and instead of retreating into depression, I kicked into hypomania. Then I harnessed as much of it as I could and channeled it to work for me.

Here’s the sitch. My longest and most vicious major depressive episode (which lasted literally several years, even when I was under treatment and on medication) was triggered by, among other things, massive financial problems. (There were other factors involved: health problems, family health problems, family problems, irrational thinking, strained relationships, and bad ol’ neurotransmitters.) I was unable to work. There was plenty of anxiety along with the depression, you can be sure.

So here I am again, almost a decade later, once again in dire financial straits. I’m able to work, but only part-time and telecommuting. Then one of my biggest, most reliable clients cut way, way back. I made the mortgage this month, but next month looks iffy at best.

In the past, this would have resulted in major mental symptoms, and physical ones as well. (Better you shouldn’t ask, but my digestive tract responds to stress in an overwhelming manner. I know, TMI.) I would be immobilized, unresponsive, and spend most of my days on the sofa when I wasn’t in the bathroom. I would abandon the financial problems – and myself – to my husband’s care, for as long as he could keep everything together. Until he burned out too.

During this new version of assorted crises, I seem to have a better handle on things, and I credit hypomania. I am trying to better the situation, though not yet particularly effectively, but steadily.

I am looking for new clients and more work from my old ones. I am looking for other sorts of telecommuting jobs, and even part-time outside work that seems to be within my modest-at-this-point capabilities.

(This process is hindered by the fact that all the job search engines are lousy. When I say I am a writer, I get leads for technical aerospace writing and service writers for car repair shops. When I say I’m an editor, I get invitations to become a driver for Uber. True story.)

I pursue these avenues every day. Soon after this post goes up, I have a networking “date” with a former client and a former co-worker.

And in the meantime? When the days stretch out with nothing happening and the sofa calling my name?

I blog. I work on my novel. And I take surveys.

Admittedly, none of these pursuits brings in mortgage-payment-sized money. But the surveys bring in a couple of dollars a day, which is pitiful, but helping with a getaway my husband and I planned before the finances went belly-up. (My husband is still working, but his wages alone aren’t enough to pay all the bills. We need both of us, a situation familiar to millions of people in the U.S., with or without mental illness.)

And, aside from the getaway, which it’s too late to cancel, we’ve instituted cutbacks. We typically spend way too much on food and now must revisit our newly married days, when we subsisted on mac-n-cheese and tomato sandwiches. It’ll be good for us, I tell myself. We could both stand to lose some weight.

I don’t know how long my “proactive hypomania” will last, when our financial situation will improve, or whether my energy level will survive after it does. Or, for that matter, whether we’ll end up eating cat food under the Third Street Bridge and fighting stray dogs for cold french fries.

But right now, for now, I’m dealing. And that’s something I couldn’t do before.

Tracking Your Moods: Low-Tech, High-Tech, and In Between

Many therapists and people with bipolar disorder recommend journaling as a practice that allows you to track your moods and figure out what your triggers are. And many individuals do well with journaling.

I didn’t, however. I tried starting a journal of what I was doing and what I accomplished daily. It rapidly turned boring and whiny. My entries looked like this:

Accomplishments:

  1. Paid cell phone.
  2. Forced myself to finish work assignment.
  3. Finally got off that stupid level of that horrible Candy Crush.

Writing is what I do, but journaling, especially when depressed, was an unrelenting series of pitiful nothing. Instead, I started this blog (on 1/7/14). In my blog, I could write about anything. Still, it wasn’t much good as a way to track my daily moods.

Technology is starting to address that problem. Recently some inventions have come on the market that promise to help you track your moods not just daily, but hourly (or even more often). Most of these devices resemble what would happen if a Fitbit and a mood ring had a child.

Most of them claim to monitor your moods by tracking your heart rate and/or your breathing. (One notes that it tracks your steps too, so you don’t need an extra device to do that. Another promises to monitor galvanic skin response, pulse, and skin temperature, which sounds more like a lie detector than mood tracking.) Then you take that data and compare them with what you were doing at the time and voilà – a mood journal.

Of course, these devices make certain assumptions – for example, that when your heart rate is elevated, you are anxious or tense. Needless to say, there are plenty of other things that can raise your heart rate and breathing. Sex, for one. Or running. Neither one of which is necessarily a source of anxiety for everyone. There is, as far as I can see, no way for the device to tell when you are depressed. They appear to assume that everything except anxiety is normal.

Then there’s the fact that you still have to journal. The devices work on the theory that you can look for patterns in your breathing and respiration, then figure out what you were doing when that happened. Upgraded devices and apps are planned that will add calendar and location functions to make this easier. But if you’re in your house the whole time the moods are happening, it won’t tell you much.

(One brand of these devices is available only from an employer, health plan, or EAP, which, if you ask me, is pretty creepy. If there’s anyone I don’t want to have information about my moods, it’s my employer.)

My friend Mike came up with an in-between solution that uses both higher-tech and lower-tech approaches to monitoring his moods. Over a period of several months, Mike had been on four different drug regimens for depression. Not all of them worked, and he was unsure which did the most good.

His idea was to go to his social media and chat apps and take a look at when he was the most active, engaged, and responsive. Then he looked at what medication he was on at the time. He noticed, for example, that in the first few weeks of April, he was posting more about accomplishments and responding to others’ posts and chat messages. A quick check of his pharmacy records and he had a pretty good idea of which medications were working best. No journaling involved – the evidence of his increased energy was right there in front of him, already recorded. And no $150 expense for an emotional tracking device.

Maybe journaling is right for you. Maybe a wearable mood tracker is the thing that will help. But don’t overlook the tools you already have. Think about them in new ways and you may already have a handle on understanding your moods and meds.

Sources

https://www.l2inc.com/daily-insights/spire-wants-to-be-the-fitbit-for-your-emotions

https://www.entrepreneur.com/article/239743

http://nerdist.com/sentios-feel-wristband-fitbit-for-your-emotions/

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