Self-Care, Part One – PLEASE

 

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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.”

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Self-Care, Part One – PLEASE

A Delicate Balance

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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

Lost At Sea

There I was, tiptoeing on the edge of the seawall, gazing numbly toward the horizon as I watched the storm begin to form and roll toward the shore. One would think I would know well enough by now to batten down the hatches and shelter myself from the impending storm, but the tempest that came wasn’t the one I was expecting. Suddenly the gale force winds caught me tightly in their grip and swept me off my feet with such violence I had no chance to fight back. Blackened clouds consumed the sky and pushed out every speck of light. The wind carried me out and plunged me into the dark and stormy sea. My lungs quickly filled with water, forcing me to sink farther down into the depths. Simultaneously drowning and caught in a riptide, I went with my first instinct: fight for my life. I thrashed and kicked and squirmed until every ounce of energy had left my body, leaving me floating lifelessly in the abyss. There I was, barely holding onto consciousness, suspended in the ocean, well below the surface.

Then I saw a glimmer of light shining down through the water above. Just as I began to swim toward it, the current kicked in, wrapping itself around my body, dragging me through the water like a rag doll. A burst of energy surged through my body, and I started swimming slowly with the current, pushing myself toward the surface. But each stroke I took was countered by the current, negating any progress that I was making. I looked ahead and noticed the upward slope of the seafloor below me. My despair and hopelessness disappeared – I was so close to safety. Calm and clarity filled my body and I began to swim toward the surface again. For the first time, I was making progress, I was getting closer. Finally, I reached the surface.

Just as I took a breath, a rogue wave crashed over and slammed me back down into the depths. I resurfaced, just to be slammed down yet again. That time I gave up. The waves tossed me back and forth, above and below the surface, allowing me just a moment to catch my breath before they dragged me back down again. I succumbed to the waves, accepted that I was at their mercy, just in time for me to experience the impact of my body being repeatedly thrown against the rocks just shy of the shoreline. Again. Again. Again.

After what seemed like an eternity, I found myself bloody, bruised, and broken, lying face down on the sandy shore, the waves flowing ever so gently at my feet. With all that was left in me, I rolled onto my back and peered up at the sky. The sun was beginning to peek through the grey and dreary clouds. I had survived.

Living with Bipolar II Disorder means that I have the “pleasure” of experiencing episodes of both depression and hypomania. These episodes can occur suddenly, out of nowhere, but they can also be triggered and exacerbated by a number of things. For many years, when spring approaches, I have tended to swing into hypomania. This year, however, I have been experiencing a depressive episode. I believe that there are certain stimuli and stressors that I am currently dealing with that have affected this year ’s seasonal mood swing. I expected a hypomanic episode, and I felt adequately prepared to handle it. But this year it has been incredibly difficult for me to use my coping skills to avoid plummeting deeply into depression.

For so long it has been difficult for me to be able to explain what a depressive episode feels like, but an image of it came to me this week, and I wanted to attempt to put it into words. So here it is!

Thankfully, I am starting to come out of this episode, or so I hope. I’m blessed beyond measure to have an incredible support system to help me get through to the other side. Recovery has not been easy, nor will it ever be, but I will continue to celebrate the progress that I have made over the years.

Thanks for reading.

“Some days you will feel like the ocean. Some days you will feel like you are drowning in it.” -Lora Mathis

Lost At Sea

On Repeat.

It happened again tonight.

And times like these are what make me question why I even fight to continue to live. This isn’t who I want to be, this isn’t who I present myself as; this is the person I’ve worked so hard to leave behind.

And again, I’ve failed.

I have prayed to see the days where I lose control fall far behind me. I have worked endlessly and tirelessly through therapy, workbooks, skill sets, self development books, support groups, Bible studies, and damn near everything you could possibly think of to overcome this, and I still fall short. It makes me wonder if there is anything I’m doing right, if there is anything about this hell that will ever change. The battle is always uphill and I am constantly outnumbered by the cannons my brain fires day in and day out.

And here I sit, sobbing again on my bed, having yelled and screamed until my throat is sore and my voice is hoarse. Bits and pieces of belongings that were hurled around the room in a fit of rage lie on the floor. My knuckles are bruised and I’m certain those aren’t the only wounds that will have appeared when the sun rises in a few short hours.

I lost control. Again. It’s neverending. The rage consumes me. And the harder I fight it, the harder it fights back. Or so it seems.

And what scares me the most is knowing how little control I actually have.

And here I sit, feeling sorry but unable to utter those words.

And I wonder how much longer it will be until I bring my own world down around me.

And all I want is for it to end.

And this is why I spend most of my days wanting to die.

And this is why I hate myself with every bit of my being.

This is my hell. I’m stuck on repeat.

On Repeat.

Candor & Courage.

All I want to do is help other people who struggle with mental illness. This is why I do not hesitate to talk about my experience with my disorders, medications, the mental health care system, and the resources that I’ve used. I encourage those who reach out to me to be honest with their therapists, doctors, medication providers, and their support system to ensure that they are able to receive the treatment and care that they need. Over the last ten years, I have cycled viciously between seasons, moods, medications, endeavors, and levels of stability. Though I have been in what I consider to be recovery for about 2 years now, I have recently started to realize how much time I have actually spent building a smoke screen.

A fellow classmate of mine had mentioned to me about this time last year how impressed he was with me being as involved in as many different things as I was, and still being able to handle full time school, my mental health, and my marriage. I love being out and doing things, meeting new people, finding new opportunities to help others and giving back to my community, but I struggle with being able to set boundaries for myself. Saying “no” is exceptionally difficult for me-I want to help everyone and do everything. And this is where the problem begins.

So much of my time has been spent pouring into other activities, some of which I feel strongly compelled to do and others that I feel awkwardly obligated to, that I am starting to burn myself out. I am so exhausted that I do not have the energy to take care of myself, yet I continue to commit myself to things simply because I am unable to tell someone that I care about “no.” Maybe part of that comes from one of several ways that BPD manifests itself: intense fear of abandonment. If I can’t help someone, they will stop liking me! They won’t want to be my friend anymore! They will never ask for my help or help me when I ask them! Therefore, I always have to say yes. I always have to put others before myself because my mind tells me that, if I don’t, I will be alone.

Doing this has done nothing but impede my progress. I am so exhausted most days that I barely have the energy to cook for or feed myself or my husband, that the laundry piles up for two weeks before Nick finally decides to go ahead and take care of it, that all I can manage to do is pace around the house, mindlessly scrolling through my various social media accounts and chain smoking through an entire pack of cigarettes.

Yeah, it’s been years since I’ve been hospitalized or had a suicide attempt, but when I take a real, honest look at my life, I have just barely been scraping by. I’ve been broadcasting to the world that I’m doing much better than I really am. I’ve been waking up every morning and putting on a mask to show the world that I am a shining light of hope, when I still have a tempest brewing inside of my own mind. How can I help others if I allow them to see what I am really going through? Is putting this mask on the right thing to do, the way that I am supposed to push myself through recovery? Or is it only bringing more pain and damage into my life?

I woke up today feeling worthless, conflicted, and empty. After a nice chat with my grandmother about my internal conflict to start the day, I realized that I have a lot to reevaluate in my life. Some of the new commitments that I have taken on recently have proven in a short time to be necessary additions to my life and some of the commitments that I have been conflicted about and struggling with incorporating into my schedule for awhile now are going to have to go. It’s also time for me to go back to being transparent, to retire this mask and not be afraid to ask others for help when I need it, to take some of my own advice for once. I have to remind myself the same way that I remind others that it is not a sign of weakness to ask for help, to say that you’re having a bad day, to ask for prayers or good vibes or a hug or some space.

Most importantly, I need to start every day with God, spending time with Him in prayer, hearing His voice through scripture, and giving Him all the things that I possibly can. Yes, I am still sick, and I will be for the rest of my life, but God has a plan for me and I know He will do incredible things through me once I being to strengthen my relationship with Him and allow His presence to permeate all of the different parts of my life. He has brought me this far with what He has put into my life and I know without a doubt that He will continue to provide for me whatever I need.

Thanks for reading.

xoxo, Christina

So humble yourselves under the mighty power of God, and at the right time He will life you up in honor. Give all your worries and cares to God, for He cares for you. 1 Peter 5:6-7

Candor & Courage.

The Cookie Tree.

When I was in the third grade, our class put on a class play. It was a cute and short play called “The Cookie Tree” which I have since come to learn also happens to be a children’s book (or maybe I knew that then and forgot…who knows?). Now, the story takes place in a small town, where nothing exciting ever happens and everyone knows everyone. One night, all of the people in the town wake up to a cookie tree having sprouted in the middle of the town square that everyone thought was something bad. Eventually one of the children suggests to eat a cookie, then everyone eats the cookies from the tree and realize that it was, in fact, a blessing.

I was pretty shy during my younger years (I know that’s hard to imagine if you know me now) and was fortunate enough to have only one line in the entire play. That line just so happened to be: “Well, everything does happen for something!

From the day I was finally diagnosed, I have wondered why this had to happen to me. Why do I have to spend every waking moment of every day battling with my own mind? Why do I have to go through the rest of my life wondering how long I have left before I finally had a successful suicide attempt? Why do I have to have that constant worry in my mind that every single person that I know and love is going to leave me? Why did I have to spend so many years damaging my brain, my body, my relationships, and my life?

I’m finally starting to see the answer. It’s getting clearer with each day.

My disorders are my cookie tree. Although it can clearly be argued that I have had several of these disorders for the majority of my life, when I was diagnosed at 17, suddenly there was something that appeared to be evil crashing into my life. I spent years thinking that my disorders were evil, that they were going to completely destroy my life and be the reason why I would never be able to amount to anything. As unexpected and disruptive as the whole process was and continues to be, I can now see it for the blessing that it really is.

Many people like the saying “God doesn’t give you anything that you can’t handle.” I don’t necessarily have anything against this saying, but it’s not really the most important component of my situation. God definitely blessed me with the strength to endure the battle with my disorders and also with the best support system I could possibly have, but He gave me more than that.

The struggles I have endured and overcome have equipped me with the ability to teach others. Not only can I teach my peers who have similar disorders as me about resources that are available to them, but I can teach people who do not live with mental health disorders about what it really means to struggle with them on a daily basis and to teach them how to be supportive of those who do. I can use my personal experiences in conjunction with my God-give empathy and compassion to help others with whom I share struggles gain support and reach recovery.

My blessing is being able to see what I previously thought was a curse, and what so many others look at with disgust and disapproval, as as gift.

Thanks for reading. 

xoxo, Christina
“What seems to us as bitter trials are often blessings in disguise.” -Oscar Wilde

The Cookie Tree.

Fight to the Death.

Having a mental illness is exhausting, not only for me, but for all of those around me who have to deal with the ups and downs associated with my array of disorders. I, just like everyone else, have good days as well as bad days: some are a direct result of my disorders and others are just because it’s a part of life, part of being a human. The past two years have been full of learning opportunities and experiences that have allowed me to grow and cope with my diagnoses in a more effective and productive manner and without medication. This being said, I am fully aware of the fact that the relative stability I am currently experiencing may end up being short-lived.

Being in recovery doesn’t mean that I have completely escaped the death grip of mental illness. I still have to fight this battle every moment of every day, whether that means ripping myself out of bed in the morning, not sending a text message when my emotions are high, or giving my credit card to my husband. None of this is easy, especially when my brain is telling me to do the exact opposite and I would love to be able to honestly say that doing these things has become easier over time, but it really hasn’t. I still have to take things day by day and I still have setbacks. I’m still learning what works for me and what doesn’t.

My husband and I live with the rather grim reality that my disorders could one day end my life. As terrifying and pessimistic as that sounds, it’s the truth, and we both are aware that denying it will just cause more problems if that is where I end up. One thing that I have learned above all else is that my disorders are unpredictable. Yes, I’ve been able to identify my triggers, I have a massive toolbox of coping skills, I stopped compromising my brain through substance abuse, and I have a well-trained support system, but I don’t know what lies around the corner and if I will be equipped to handle the struggles of life later on down the road.

I want to make it perfectly clear that just because I acknowledge the possibility of my life ending by suicide does not mean that that’s what I’m expecting for my life.

I still make a decision every day to suit up and fight this battle, refusing to give up. Being realistic and being honest with myself has helped me more than anything in my journey to recovery and, for me, having the awareness that I may get back to that point again is what will ultimately save my life.

Thanks for reading.

xoxo, Christina

Fight to the Death.