Self-Care, Part One – PLEASE

 

img_6542

Self-care is so, SO incredibly important. Whether you live with chronic illness of any kind or not, it is crucial that we tend to our needs before we can effectively and efficiently function in the real world and help others. I personally feel that the way our society is built pushes us to feel the need to be constantly busy, to force ourselves to be moving, moving, moving, even when that results in burning ourselves out.

Recently, I’ve started to see images and excerpts circulating the internet and social media that are spouting the importance of self-care, yet many of these posts seem to be misconstruing what self-care really is. Granted, what self-care looks like differs between individuals, I do feel that it is important to state that it is much more than just eating a pint of Ben & Jerry’s, soaking in a luxurious bubble bath, or having a day-long Netflix binge every so often. Something else that I feel is necessary to bring attention to is the fact that self-care looks different for people who live chronic illness (physical or mental) than it does for those who do not, and even then, self-care for those who live with chronic illness will look different depending on what symptoms they may currently be experiencing.

There are many things I learned over my years of DBT (dialectical behavior therapy), yet there are a handful of things that have really stuck with me since I first began this type of therapy. Eventually, I will make a post talking about what DBT is in more depth, but for those of you who aren’t entirely familiar with it, here’s a tiny bit of information regarding this type of therapy. DBT is broken down into four different sections, all of which teach skills and equip you with tools to help deal with symptoms or to avoid triggering an episode. These four sections are mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation.

Only recently did I realize that a tool included in the emotion regulation section is essentially the same thing as self-care. That tool is called “PLEASE.” This is just one of many skills learned in DBT that has an acronym attached to it in order to make it easier to remember. The point of PLEASE is to reduce ones emotional vulnerability. This is especially important for those who live with mental health disorders such as mood disorders (depression, bipolar, etc.), anxiety disorders, and other disorders that inhibit the ability to effectively regulate and/or cope with emotions. Let me break down PLEASE.

PL – Treat Physical Illness – This is essentially taking your medication as prescribed if you have regular medications that you take. If you have a cold or another acute condition, it is important that you treat that as well. I think we can all agree that, when we are feeling physically ill, it is harder to cope with certain emotions and situations than it is when we are feeling well physically.

E – Balanced Eating – This means that you are eating balanced and nutritional meals. Avoiding foods that you are allergic to or intolerant of is incredibly important. It is also important to avoid foods that you are sensitive to, such as sugar and/or caffeine.

A – Avoid Mood-Altering Drugs – This means that you are not taking any drugs (pharmaceutical or recreational) that are not prescribed to you by a doctor, including alcohol.

S – Balanced Sleep – This means that you are getting the right amount of sleep for your body. Some people need 6 hours of sleep, and others need 10 hours of sleep. The amount of sleep needed to feel well-rested varies between individuals, so it is about what is best for you. Implementing good sleep hygiene can have an incredible and positive impact on your quality and amount of sleep.

E – Exercise – This means that you are getting some physical activity in. It does not have to be anything intense or overly strenuous. Even a quick walk around the block will suffice, especially if you haven’t exercised in awhile.

PLEASE covers the most basic aspects of our health. If you aren’t sure where to start with a self-care routine, I feel like this is a good foundation to build from, and is what I personally have built my own self-care off of. There are still times when I struggle with self-care and even these very basic components of it, which is why I have decided to break this discussion down into a series of three posts to further delve into the complexities of healthy and effective self-care for those with and without mental illness.

Check back next Monday for part two.

Thanks for reading.

“You cannot pour from an empty cup. Take care of yourself first.”

Advertisements
Self-Care, Part One – PLEASE

A Delicate Balance

img_6487

 

As you are all most likely aware, I am currently (and finally!) in mental health recovery. It has been quite the journey and process for me to reach this point, but I have worked and still work diligently at it on a daily basis. Over the years, I have frequently been asked what types of things I have done to achieve recovery. I am writing this in response to those inquiries so that those who are wondering what they can try to help make their journey a little easier can have my list as a reference. Please keep in mind that everyone is different and not everything that works for me will work for you or your loved one. These are listed in no specific order as I feel that each of these has played an equal role in my recovery. Without further ado (with the exception of my disclaimer), here is what has helped me the most in my journey to recovery.

***DISCLAIMER*** THERE IS NO MAGIC, FIX-ALL, WONDER SOLUTION FOR MENTAL ILLNESS OF ANY KIND!!!

  1. Identifying Triggers & Applying Coping Skills

    One of the most crucial things I had to do to get myself into recovery was identifying my triggers. If you do not know what a trigger is, it is an external event that can result in uncomfortable emotions or lead to psychiatric symptoms, such as elevated anxiety or a depressive episode. Triggers vary among individuals and also have a vast array of intensity. For the sake of avoiding triggering others, I will not list any examples. Identifying the things that trigger me allowed me the ability to start coping with my triggers and to determine which of the skills in my toolbox are appropriate for which situations. Certain situations are too difficult for me to be able to cope with, so I tend to avoid them completely. Other situations are things that I cannot avoid, so I do what I can to prepare myself for these situations when it is possible.
  2. Reducing Stress & Exposure to Triggers
    This is one of the most important aspects of my recovery. Reducing exposure to triggers and stress can be incredibly difficult, especially when you are trying to live a “normal” life and function in the real world. Some stressors and triggers absolutely cannot be avoided, which makes having a toolbox full of coping skills even more important. Though I realize this is not feasible for everyone, not working in a job outside of the home has made a huge difference in the occurrence of my symptoms and has been incredibly helpful with focusing on my recovery. I am fortunate enough to have a spouse who has a secure job that pays him more than enough for us to be able to live (mostly) comfortably on a single income.
  3. Setting Boundaries
    This was an extremely difficult step for me to take and I still struggle with this on a daily basis. At my core, I am a people-pleaser and an insufferable empath. Saying “no” is incredibly hard for me, especially when it comes to the people and issues I care about most. I want to help everyone as much as I can, all of the time, and do as many things as I can possibly fit into one day. This often results in me not taking care of myself and my needs. Although implementing and enforcing boundaries is still a work in progress for me, the process of doing so is allowing me to stay focused on what is necessary for my mental health and keep that at the top of my priority list.
  4. Self-Care 

    Figuring out a self-care routine is difficult for most people, whether they live with mental illness or not. We live in a society that is heavily focused on productivity and adding as much to our plates as possible, even when that means putting our well-being at risk. Self-care has become increasingly popular, but many posts circulating the internet and social media portray a skewed image of what self-care really is. I will make a post in the next week going further into what my self-care routine looks like and how I adjust my routine depending on the symptoms I am currently experiencing. Everything that I discuss in this post is included in my personal self-care and I would consider these things to be the most important components of my self-care, but there are many facets of a complete and effective self-care routine.

  5. Getting Enough Sleep

    Not getting enough sleep is not only a trigger for me but, in certain situations, is a sign that I am starting in on a hypomanic episode. Having good sleep hygiene is crucial to getting enough sleep, which in turn has a major impact on both your physical and mental health. Some of the things I do to ensure I am getting enough sleep include: going to bed around the same time every night, not consuming anything caffeinated after 12 p.m., reducing screen time in the evening hours, and having a bedtime routine (washing my face & brushing my teeth, putting on comfortable pajamas, and reading a chapter of a book before bed). When I am well rested, I am significantly more capable of handling stressors effectively and being productive during the day.
  6. Taking Treatment Seriously
    This should go without saying, but I prefer not to make assumptions or let anything go just being implied, especially with how important this step is. Therapy is hard work. There is homework (gasp!), most of which involves you doing things that are far outside of your comfort zone. Awhile back, my therapist gave me the assignment to write a list of 100 good things about a person that I have had issues with for a long time. Despite my natural aversion to writing the list based on my history with this individual, I actually did the assignment. Granted, I did not make it to 100, I did put my best effort into it and was completely genuine in the things that I came up with for it. Regardless of the fact that my list was not “complete” based upon the original assignment, it was complete in the sense that I took it seriously, which is something that I would not have done in my younger years.
    I am currently not seeing a therapist, as traveling with my husband for his job has made it so that it is not possible for me to do so, but I still try to be vigilant about using the skills and tools that I have learned from my therapy sessions.
  7. Sharing My StoryI was inspired to be open and honest about my journey with mental illness after reading the book, “Postcards from the Edge” by Carrie Fisher. Carrie’s candor about her struggles with mental illness and addiction throughout her lifetime and her role as an advocate for those struggling with them as well made an incredible impression on me. Being able to share my story has been highly therapeutic for me and has also opened my eyes to just how many of the people in my life have similar battles. Many people comment on how brave I am to share my struggles so candidly, which is something I have mixed feelings about, but just as many people have reached out to me for support.
  8. Finding Support 

    There are so many amazing resources available for those of us struggling with mental illness that go beyond standard treatment. Many of the people I know personally who live with mental illness do not have the same kind of support from their family and friends as I do. One thing that can help provide support whether this is your situation or not, is a peer-led support group. In my town, there is a local DBSA (Depression and Bipolar Support Alliance – click the link to find a group in your area) group that meets regularly. Finding this group, through the assistance of my grandmother, made a major impact on my recovery and my decision to take my mental health seriously. Other organizations also have peer-led support groups, such as NAMI (National Alliance on Mental Illness – click the link to find your local NAMI chapter), as well as local, state-funded mental health clinics. If you see a therapist or psychiatrist, they may also have resources and support groups available to you at no cost, or that are covered by your insurance. For me personally, half of the battle of accepting my disorders and getting into recovery was not feeling like I was alone. Finding support from peers who lived with the same or similar disorders as me made a significant difference in my life.

 

I hope this list is at least somewhat helpful to those who are curious about my personal process for reaching and staying in recovery. Please remember that what works for me may or may not work for others. I simply share what has worked for me to help provide a starting point for others who are struggling to get started or looking for ideas. For those of you who are living in mental health recovery, I would love to hear what things have been helpful for you personally in your recovery!

 

Thanks for reading.

A Delicate Balance

My Own Worst Enemy. 

I have discovered that one of the things that allows me to cope with my disorders is my ability to discuss them with most anyone I meet. Many people have called me brave merely for the fact that I am open and honest about my disorders and what it’s like to live with them on a daily basis. Most of my family members and friends are very well aware of my mental health journey, especially those who have rolled with the punches and stuck by my side through some intense, difficult, and exhausting situations. I have good days and I have bad days, just as everyone else does. Lately, the good days have been more frequent and the bad days have been fewer and farther between.

In the 8th grade, I began experiencing symptoms of depression and was prescribed antidepressants for the first time. I was 14. Back in 2006, when I was a junior in high school, I was in an abusive relationship that had quite the ugly ending. This resulted in my first psychotic break and suicide attempt, landing me in a psychiatric hospital for the first time and leading to my initial diagnoses of Bipolar II, Post Traumatic Stress, Generalized Anxiety, and Borderline Personality disorders at the age of 17. The next 8 years of my life were a whirlwind of pharmaceutical cocktails, street drugs to numb the pain the prescriptions couldn’t, failed suicide attempts, emergency room visits, and overall emotional instability.

I was comfortably numb and in excruciating pain simultaneously. I had lost myself before I had even had the chance to begin to figure out who I was supposed to be and I was completely incapable of coping with the constant turbulence inside my head. I was still so young yet I could see nothing on the road ahead of me. I had no hope.

Getting myself into recovery has been quite the adventure, to say the least. Two years ago, I gave up on my medication, just as I had done many times before. This time was different, however; I was more properly educated about my disorders and my treatment options, I was prepared to work my ass off, and I had a serious long term plan.

When I was 18, I started DBT (dialectic behavioral therapy) at a center in Seattle that worked directly with its creator, Dr. Marsha Linehan. I spent four years on and off receiving what was supposed to be the best care available for my disorders. The only drawback was the fact that I was not ready to put in the effort and focus that is necessary for it to work. In the summer of 2014, I began attending a DBT therapy group at the local state funded mental health agency after having spent a few months working with an individual therapist there, who also happened to be one of the facilitators of the DBT group. I was nervous at first, not only about starting from scratch with a new therapist at an agency that has quite the reputation in my area, but also about still not being ready to put the effort in that DBT requires for maximum effectiveness.

Much to my amazement, things really were different this time. I was able to complete an entire 33 week round of DBT group therapy which wrapped up at the end of March. Throughout the time I participated in the group, I also saw my individual therapist once a week and have continued to see him after finishing the DBT group. I currently see him less frequently and, although I am at the verge of being discharged due to the significant amount of improvement I have made, I continue to see him so that I have someone to check in with, help keep me on track with my goals, and provide guidance and advice that I may need as I encounter different situations in life.

Self-sabotage has been a huge hurdle for me to overcome. For as long as I can remember, whenever I would get myself to the point of doing something right or have things going relatively well, I would somehow find a way to convince myself that it wasn’t going to last and that I would find a way to screw it up in one way or another, which would eventually lead to me actively doing things to burning all of the bridges that I had built and having to start over. I get overwhelmed easily at times, so becoming aware of this and figuring out a plan for when I start feeling the need to self-sabotage has become an essential part of keeping myself in recovery. Having to start over always magnified my feelings of uselessness and unworthiness.

It’s difficult to explain to people who do not experience first hand the hell that it is to have your own mind be your own worst enemy. I know, deep down, that I have the power to overcome even the darkest and strongest of my impulses, but no coherent words can describe the feeling of having such a powerful part of your mind pushing you in the opposite direction and clouding every decision you make. Without the support system I have had throughout my entire journey and the resources that I have been able to access, I would not be where I am today, but that doesn’t mean that each day is less of a battle now that I am in recovery. I still fight against my own mind every single day to push through and do as much of what I need to as possible. This is still a process, however, and it is one that I have yet to completely master. Each day I learn something new and try different ways to maintain my recovery. It has been much harder than I expected, but when I really think about it, why wouldn’t it be difficult to “rewire” your brain and try to do almost everything you’ve ever done in a completely different way?

Some of the changes that I have been working on incorporating into my routine have been beginning to prove quite helpful despite that I am struggling with a handful of them. Eating right and being active have been especially difficult for me as these things have never really been a part of my routine and also because I am just so burnt out after trying to keep myself together throughout the day between work, school, and other various activities that I do not have the energy to cook a nutritious meal or get myself to the gym. Meditation is something that I have been doing at least three times a week, but I know that stepping this up and doing it daily (which was my original goal…sigh…) would help me be able to actually keep myself together with less effort on a daily basis, as reflected by how my days go when I do meditate. Rediscovering my faith is another journey that I have been exploring lately. I grew up going to church but separated myself from organized religion when I was in high school due to some events that took place with my peers from church when I had joined the high school’s Gay-Straight Alliance. Recent conversations and interactions with others, as well as some personal experiences, have started to reignite the faith that I have always had lurking in the corners of my heart and mind, so I have opened up to exploring this avenue again.

It takes a hefty toolbox to be able to handle certain disorders with or without medication. My goal has been to fill my toolbox as much as I can with healthy and natural practices to reduce and be able to cope with my symptoms as much as possible. Opening my mind to the fact that I can do this without the medication and arming myself with the proper tools are the most important things that I can do to meet my ultimate goal of staying in recovery and having a “normal” life with mental illness. As previously mentioned, this is and most likely always will be a daily battle, but I have had a taste of what life can be like if I stay on track, and I am at a point in my life where I will not let myself continue to be my own worst enemy.

Thanks for reading!

xoxo, Christina

“Progress is impossible without change, and those who cannot change their minds cannot change anything.” -George Bernard Shaw

My Own Worst Enemy.