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Senses of Self Care 29/10/2011

There’s something centring about looking after yourself.  Basic self-care.  Hygiene and grooming activities.  There are things among them that have qualities that can relax and alert us if we are mindful of what we are doing.  A couple of posts ago I wrote about mindfulness and the senses in Send in the Senses .   Today I would like to show you some of the ways that these principles can be integrated into everyday activities.

Warm water over the skin is relaxing.  It’s soothing.  You can just stand there under warm water in the shower or sit in a warm bath and let it calm you.  (being conscious of your water consumption of course)

Or if you want to you can make it more soothing you can add a scented cleanser and smooth it on with your hands or a soft cloth.  Then again – if you want to jazz it up a little, you choose a more uplifting stimulating scent and a courser cloth or a loofah.  And okay – so the guys mightn’t be so into the scented soaps as the girls  – but the rest still works as well for them even without the scents.  On top of that are the sounds of the water and visual stimuli of the water running over you and the shower or lapping against the sides of the bath and the intricacies of your own bathroom and showering routine.

After washing, you think about how you are going to use your towel to dry yourself.  Vigorous rubbing will invigorate the senses, while gentle strokes with the towel are likely to be more soothing.  Alternately, you might wrap yourself in a towel or terry towelling bathrobe and wander around the house until you dry naturally.

If you’re looking for a basic activity that is inclined to stimulate the senses, then look no further than brushing your teeth.  A toothbrush in decent condition with toothpaste on it brushed over the teeth and gums will arouse the senses of touch, taste and smell.  Flossing is great if you’re anxious or need to slow down or focus because you have to do it deliberately and if you want to do it properly, you can’t do it quickly – so it forces you to slow down and focus your attention but gives you a task to do it with.

Painting your nails is great for the same reason.  There is a need for controlled movement – so you need to slow down and focus your attention.  Great for regulating anxiety.  It is also something that can make you feel nice after you’ve finished.  So nail painting incorporates controlled touch, slow and controlled movement, a stimulating smell – which is not necessarily why you’ve chosen the task – but it won’t put you to sleep.  I was stuck in one city while the rest of my family were in another when my Grandfather died and I couldn’t be with them.  I was very unwell with depression at the time and quite distressed.  In the end, painting my toenails is what I did to calm myself down to a point where I could think reasonably.  Then I could start to deal with my situation and emotions more logically.

For those who like a face mask – this is a beauty.  Deep touch is relaxing, so you apply the mask with a firm touch.  You follow the directions and wait while it sets, then when it is done you rinse it off.  Now to rinse it off, follow the directions on the packet but remember: warm water – calming, cool water – alerting; and soft cloth and/or gentle strokes with firm pressure when rinsing will be calming, while a courser cloth and/or more vigorous or uneven strokes while rinsing will be more alerting.  My own preference when using a mask is to rinse with a course cloth but gently with firm, smooth strokes in warm water.

If you need to shave, this is a good example of an activity that involves slow, deliberate movement.  Focusing on the movement and the sensations of the shaver on the skin can be very effective.  Most would find that this would alert touch and movement sensations, potentially smell also depending upon things like shaving creams and so on.

Another one – very touch and movement based that I find therapeutic at time is waxing.  Great for anger management.  Rip into the leg waxing.  It’s systematic.  You have to regulate it.  You eventually slow down because the waxing process requires you to.  But it’s also a useful buffer for stress, a way of alerting the senses to wake up when you’re weary or just getting rid of unwanted hair…  Waxing is rich in touch (temperature, pressure etc), it involves controlled movement and you are using your sight to inspect your work.

Brushing or combing your hair can be either relaxing or alerting depending upon how you go about it, although if you use a comb it is more likely that the result will be an alerting sensation.  When using a brush however, if one uses long smooth strokes the effect is quite different to brief, sharp strokes.  The former is calming, the latter more alerting.  Experimenting with different styles of brushing can be a great way to explore ways that touch influences the senses.

Think about all of the self-care activities that you do on a regular basis.  Washing and drying yourself, washing your hair, styling your hair, cleaning your teeth, washing your hands, washing your face, moisturising, using deodorant, brushing your hair, shaving and/or waxing, cleaning your ears, dressing, cleaning your nails – anything you can think of … Take some time to think about what sensory qualities there are to the tasks.  What movements, use of vision, scents, smells, touch, sounds, tastes are associated with them?  How are you positioned for them? Where is your balance? Your centre of gravity?  Which of these have alerting qualities? Which have calming ones? Are there qualities to any to the tasks that you do regularly that could be useful to you in other ways?

 

How Frail Humanity 26/10/2011

I have been reading a lot lately that has reminded me how frail humanity is.  How vulnerable we are.  Our bodies, our nervous systems, the balances of the chemicals in various systems that keep us functioning are so finely balanced.  And so, so often is our sense of self.  Our sense of our own competence and worth.  We become vulnerable to so many thoughts and perceptions that we may once have never thought possible – may once have thought weak once this is penetrated.

I have been reading people’s writings – people who are feeling worthless, yet working daily at moving forward – at overcoming illnesses that sap energy and personal reserves like parasites.  For as surely as I breathe Depression and Bipolar Disorder, Seasonal Affective Disorders, Psychosis, Schizophrenia, Personality Disorders and Anxiety are parasites that draw upon the heart and soul, the will and desire, the sense of purpose and confidence in one’s own capacity.

And yet as I read I see evidence that these illnesses and disorders are liars.  I read words written by brave people who are still wrestling, still fighting, still entering the ring round after round.  Sometimes they come out on top.  Sometimes they come out feeling hopeless and defeated.  But I say this.  While people are still willing to step into the ring, they are not losing the war.

The human body, while fragile is also amazingly robust.  We survive enormous things.  Our bodies fight infections.  It is well designed to protect its more fragile organs.  It is our sense of self that is the fragile part.

Each person is unique.

Each person has a different combination of qualities – of strengths and weaknesses to the next.

Each person has something about them that is admirable.  Worthy of respect.

Each person is entitled to dignity.

It is hard to breathe, hard to grow, hard to believe any of these things amid the lies of mental illness when it is out of control and where it has left its scars.  It is hard to believe that friends still care when they are getting on with their lives while you are feeling stagnant and stuck wrestling just to keep your head just above water.  If they haven’t been here they can’t possibly understand that you are feeling left behind.  And so friendships grow fragile too.

Families tell us anything from we “just need to try harder” to telling us “not to push ourselves” because we’re too fragile.  Sometimes they expect the world of us – and sometimes they seem to expect nothing at all.  I’m not sure which is worse.  Those who push too hard make us feel like we are inadequate and seem to think that we are just lazy – and that does wonders for our sense of self.  Those who seem to think that we are too fragile to try don’t inspire hope that anything will ever get better although they mean well.  How hard it is for a family to understand if they have never been here.  They usually mean for the best – which leaves us feeling guilty for being annoyed by at their lack of understanding.  How do we deal with this?  Most of the time when we’re not well we’re not in a state where we feel eloquent enough to express ourselves well and we fear that it will all come out the wrong way.  Sometimes it has before.  And so some of us feel that our family is far from us.

And so we stand; feeling as though we could break at any moment.  Our lives, our friendships, our relationships with our families, our very selves.

Hear me say – I believe that people who make it to this point can still be strong.  Simply deceived.

Yes, your situation may be fragile.  This does not mean that you are weak, undeserving of hope or inadequate.

You don’t have to believe me.  You don’t have to believe it’s true as though you have had some kind of epiphany.

But treat the thoughts with the suspicion they deserve.  Perhaps the same suspicion that you treat my claims.  Keep stepping up for another day.  Keep looking for tools to arm yourself with – mindfulness, sensory strategies, CBT, relaxation (see the link in today’s poll), self-affirming statements, support people, distraction, your medications – whatever is positive and works for you.

You too have strength within you.  Even you – the one who doesn’t believe me yet.

 

Send in the Senses 23/10/2011

An area that is starting to grow in mental health is an intervention called Sensory Modulation.  It is used in a number of different ways and some people use it only in part.  Some people may have come across ‘grounding techniques’ and ‘self-soothing techniques’.  There is a cross-over between Sensory Modulation and distraction as a technique to deal with difficulties.  It is a sub-branch within the world of Mindfulness and involves use of activity and engagement of the senses for therapeutic purposes.  It is a big area for Occupational Therapists, Diversional Therapists and is starting to feature in Nursing literature, particularly for use in hospitals to try to find ways to reduce people’s levels of distress without having to resort to extra medication and seclusion.  Studies are showing promising results.

The Senses

Despite the way that we usually talk about five senses, we have actually have seven senses.  We are used to thinking of our senses in terms of taste, touch, sight, smell and sound.  However there are two more that we very rarely talk about.

The first of these is called proprioception.  Proprioception is communication between your muscles and your brain.  This is how your brain knows what your muscles are doing – when they are stretching, flexing and where your body is in space.  It is proprioception that enables you to match the position of one arm to the position of the other with your eyes shut.

The second is a vestibular sensation.  This is what gives us our sense of balance and the sense that we are moving in space like when we are in a car.  It is also the sensation that gives us the feeling of dizziness and nausea when it is out of kilter.

Some people also differentiate between deep touch and light touch when working with the senses because your body often responds differently to the different types of touch.  Think of the difference between being massaged and being tickled.

What is Sensory Modulation & how does it work?

Sensory Modulation involves using different types of activity or stimuli to calm or alert one or more of the seven senses.  This in turn can feed into the way that a person is feeling or reacting to a situation, a stressor or the environment.  So if feeling anxious and having anxious thoughts churning over through ones head someone might choose to do something that they know will engage the senses in a soothing way for them eg using a rocking chair, listening to music that they like that has a tempo of approx 60 beats per min whilst being mindful of the sensations; or they may choose to ground and/or distract themselves with something that alerts the senses and redirects their attention, perhaps using the tension in their muscles by going for a run or walk, again engaging awareness of the movement of the muscle groups and the engagement of the senses with the environment around.

Essentially, you take control of your senses and use them to serve your advantage.

Mindfulness & the Senses

Some of the ways that you can use your senses with mindfulness include:

Grounding

Grounding techniques are active techniques to help you to orient and focus on the present and to distract or self-soothe when you’re feeling distressed.  When you are feeling ‘out of sync’ they can help emotionally, physically, mentally and spiritually.  If you know what you respond to best – you can even be prepared for times of crisis or for prevention if you are feeling triggered.

Some activities that people use to help ground themselves include

  • A hot or cold shower
  • Eating hot balls or sour balls, chilli, lemon – alerting tastes
  • Breathing exercises
  • Yoga
  • Using a balance ball
  • Cleaning
  • Yard work
  • Wearing weighted item eg back pack, ankle weights
  • Petting dog or cat
  • Warm or cold flannel to the face and neck
  • playing with a stress ball
  • Aromatherapy
  • Moving furniture
  • Holding or chewing ice
  • Jumping rope or doing star jumps
  • Stretching
  • Running or walking
  • Lifting weights
  • Push-ups
  • clenching and unclenching muscles (isometric exercises)
  • playing drums or other musical instruments
  • Pottery
  • Rocking in a rocking chair
  • Dancing
  • Listening to music
  • Waxing
  • Journaling

Other activities that can be used for self-soothing or for orienting and alerting oneself capitalise on the calming and alerting features of the stimuli.  Some examples of these include:

Calming Sensations                                                                               Alerting Sensations

Hot shower/bath                                                                                 Cold or cool shower/bath

Holding/petting a pet                                                                        Holding ice in hand or to face

Warmth of fireplace                                                                            Being in a cool room

Wrapping in a heavy blanket                                                          Wrapping in cool bed sheets

Massage/Deep pressure touch                                                      Light touch

Isometric(the muscles don’t move) exercises/yoga              Aerobic exercise

Leisure walks                                                                                         Power walks

Dusting powder/powder puff over your body                        Rubber band wrist snapping

Slow/rhythmic music                                                                        Fast paced/upbeat music

Calming sounds of nature eg ocean                                             Alerting sounds of nature eg birds

Humming/singing quietly                                                               Humming/singing loudly

Soothing scents (oils/lotions/candles)                                     Strong scents (oils/lotions/candles)

Soft materials/textures                                                                   Rough or prickly materials/fabrics

Rocking in a rocking chair                                                              A bumpy car ride

Swinging on a swing                                                                           Spinning on a swing

Slow rhythmic motions                                                                   Fast and/or jerky movements

soft/low lighting                                                                                 Bright or flashing lights

Decaf herbal teas                                                                                Drinking coffee

Chewing gum                                                                                        Biting into an icy-pole

Chewy or crunchy foods/ lollies                                                  Sour or hot foods/ lollies

What to do with these activities – A bigger picture

The idea then is to consider the primary areas of difficulty that you encounter.  Do you

  • get overwhelmed
  • get voices
  • Get angry
  • Get anxious
  • Depressed
  • Struggle with negative thoughts
  • Feel disconnected
  • feel triggered by something …?

Think about a) things that you can use to alert or distract yourself;

b) things that you can use to do to calm or comfort yourself;

c) things that you can do to help improve the moment; (something you enjoy, a treat, something to make you feel better)

Often you may need to do all three in that order – but not always.  Regulating your reaction, however, may be more than a single step process.

What senses do you respond to most strongly?

Different people are more responsive to different senses.  Some people love touch.  Others squirm.  Some love movement.  Others enjoy scents.  We’re all wired differently.  How do you think you are ‘wired’?  What are your preferred senses for comforting and alerting yourself?

Think about what kind of movement you enjoy (eg exercise, rocking chair, doodling, shopping, cleaning, theme park rides, skating, building, sports activities)

What kind of Touch & Temperature do you like (eg massage, sitting by fire, shower/bath, knitting, sunshine/shade, lotions, playing instruments, art, fiddling with things, doing your hair, heavy blankets/quilts)

What kind of  auditory/listening stimuli you like (eg silence, running water, music, rain, relaxation soundtracks, wind chimes, theatre, a purring cat, people talking)?

What kind of visual stimuli you like to look at (eg scenery, photos, lava lamp, movies, window shopping, reading, fish in a tank, art)?

What kind of scents do you like or respond to (eg scented candles and oils, coffee, perfumes and aftershaves, flowers, fruit, herbal tea, fabric after being hung out to dry, chopped wood, forests)?

Think also about what kind of gustatorytastes and chewing sensations you respond to (eg chewing gum, crunchy food, sour food, sucking a thickshake through a straw, yawning, deep breathing, listerine, blowing bubbles, hot balls, drinking coffee or hot chocolate, fizzy drinks, sucking a lollypop)

Making a Plan

When you have thought about the types of activities that you respond to.  Make a note of half a dozen things that you think would be most helpful when you are distressed.

Why not set aside a place or a kit where you have some if not all of those things ready to go and on hand when and if you need them?

Knowing how your senses work can help you tap into them better for relaxation, recreation and for giving yourself a jolt if you need one.  I have found ideas from studying this stuff that are great for my recreation, rest as well as helping me when I am worked up or struggling to focus.  I hope that it’s useful to you also.

If you are interested in more information, information about making a sensory kit or a questionnaire about your sensory profile, please leave me a message in the comments and I will get something back to you.

(Credit to a lot of the lists goes to a combination of published resources that I have referred to, some of which have no author attached, majority of examples listed resourced from Tina Champaign’s website)

 

Hair Raising Therapy

I had only two posts for this weekend.

I had finished and scheduled them by Thursday.

My parents have come to visit – so I didn’t think I’d have time to blog.

But here’s the thing …

I’m too interested in the things I blog about to leave it alone.

I’ve enjoyed sharing some of my early experiences of Mindfulness.  I hope that some people have found it valuable and that it has helped some to grasp a little more clearly the concepts behind it.

Being present in the moment, self-aware and able to be aware of your environment or choose to filter what you attend to.  Being able to focus your attention, your thoughts and meditate on or observe things.  To be deliberate in all of this.

It is a refreshing experience and helpful for many things from distraction to relaxation, to stress management and through to managing early warning signs and symptoms.  If you’ve not had the chance to learn it, I would highly recommend it.  It is a more concrete skill than it sounds at times.

I have had fun today.  I enjoyed having my 5 and 3/4 year-old niece do my hair for me this morning (one must not leave out the three-quarters!).  When I got home (after driving for a quite a distance and stopping to get out of the car and fill up with petrol) I believe that I pulled 7 elastics and 2 clips out of my not-so-very-long hair (ie it had bunches sticking out in all directions).

I don’t think that she believed that I was really going to leave it all in until I actually left.

Playing hairdressers with one’s niece is a lot like a dare.  She knew I looked silly, and didn’t really think I’d leave her handiwork in – but wanted to see if I would.

What she doesn’t know is the kind of things I did to my own hair for the hell of it when I was in my teens and went out with still in just because I was bored.

My niece is good therapy for me.  When I am with her I forget to be anything but open to what she wants to do (except if it involves running too far or something against the rules).  I lose most of my inhibitions and allow myself to play like a kid again.  She lets me enjoy the moment in her company for just that little while – and while I am with her I feel whole.

She is my favourite anti-depressant.

What’s yours?

 

Mindfulness of the October Factor 22/10/2011

One of the factors that I have spoken of recently that has affected my mental state is the change of season.  I become more vulnerable to symptoms of Depression and need to be careful not to be taken captive by them and dragged back under the control of the black dog as he strains upon the lead.  October this year has been fraught with tension as the dog hauls away at the lead while I wrestle endlessly to bring him to heel and keep him there.  While each time he strains, I have brought him back – it takes a lot out of me and he knows it as he waits impatiently at heel for the next opportunity to pull away.  I have had a tiring month.

How do I know when things are starting to get too much?

One of the things that I have decided to work on is paying closer attention to the cues that my body gives.  It’s very easy not to be aware of these until I have a nasty headache, my shoulders ache, my muscles are all sore, I have a noticeably palpitating heart rate that makes my chest feel hollow and heavy or I feel exhausted.

I commented in my last post in closing about Mindfulness that one of the areas that I need to work on is that of noticing what is happening in the moment.  This is what I am working on at the moment.  To start with – to notice the cues that my body is giving me.  For instance, when is there a change in the level of tension at key points in my body like my neck, shoulders and jaw?  Am I breathing deep, medium or shallow breaths, what kind of rate am I breathing at?  Am I aching anywhere?  What is my heart rate like?

Now I don’t do this as a checklist and step through it or try to determine these things in a specific way.  What I am learning to do is to try to do what is called – in Mindfulness language – a ‘body scan’ at regular intervals.

What does a body scan involve?

Essentially all I do is start out by observing my breathing until I am into the mindset of observe – not control.  I then move my attention to my heart and notice and feel the rhythm of my heart beating inside me and the sensations that arise from that and enjoy that for a little bit.  From there, I start by noticing the feel of the clothes on my skin, the shoes on my feet if I’m wearing any and then move my attention to my muscles.  To scan my muscle I start by placing my attention on my toes of one foot and paying attention to them, noticing any tension or pain or other sensation, acknowledging it and – if it is tension, consciously releasing it from the muscles by either picturing it draining away or stretching and/or wiggling them.  I then do the same for the other foot and move on to the next section of my leg and do the same thing. And doing this throughout I might move through the body in a pattern something like:

  • Toes
  • Feet
  • Lower legs
  • Thighs
  • Butt
  • Abdomen
  • Lower back
  • Upper back
  • Shoulders
  • Chest
  • Upper arms
  • Lower arms and wrists
  • Hands
  • Fingers
  • Head
  • Forehead
  • Eyes
  • Nose
  • Cheeks
  • Mouth
  • Jaw
  • Tongue
  • Neck
  • Shoulders

I figure that since the shoulders bunch up so easily, it doesn’t hurt to check them again.  It doesn’t really matter what order you do it in though, nor how big or small the groups you break them up into are to a certain extent.

After scanning and relaxing all of the muscle groups, I then observe my breathing again for a moment or three before drawing my attention back to what is in front of me to do.  It doesn’t take very long, and with practice it should take perhaps a minute – maybe less.  If I try to do it when the little ‘beep’ goes on my watch on the hour (when I hear it), I should get lots of practice and stay well on top of these cues.

The goal is to be able to notice the tension before it becomes problematic and to be able to question whether I am becoming stressed before I get there.  A lot of people who do this regularly swear by it.  I guess it’s a bit like paying attention to when there is tension growing on the dog’s lead when walking a dog.  As it grows, it cues us in to the idea that the dog is growing more likely to want to get away from us.  Thus it is living with my black dog.  I must be wary of tension.

So – here’s to my next excursion into the world of mindfulness.  Noticing physiological changes and discomfort and either accepting them or letting them go without blame for their getting there.

Here’s to the next step into managing my Depression.  Noticing the cues that early warning signs are present so that I can act.  Perhaps October will improve from here on in.

Heel, Dog.  Heel.  I’m onto you.

 

A Mindful Journey 21/10/2011

One of the therapeutic approaches that I use to help manage my Depression that regular readers will have come across previously when reading my blog is Mindfulness.  Among other things it is helpful for dealing with thoughts, coping with stressors and managing physiological symptoms.  It has been used to help people manage symptoms of a range of mental health issues including Depression, Anxiety, Bipolar Disorder, psychotic illnesses, Personality Disorders and Eating Disorders.

My first experiences were vague explanations by people who I worked with about being present in the moment and awareness.  These are true and make a lot of sense now – but Mindfulness made the most sense to me after my first experiments with it with my Clinical Psychologist when I was, myself, in therapy.  The experience itself made an enormous difference to my understanding and appreciation of the discipline.  For this reason, I thought that I’d share with you some of my experiences with the use of Mindfulness.

The first exercise

My introduction to mindfulness included eating a mandarin.  The exercise involved taking the time to notice all of the sensations that were involved.  The scent of the fruit, the feel of the skin, the firmness of the mandarin before it was peeled, the colour, the weight, the sensation of peeling the mandarin.  I was to notice the texture of the inside outside of the skin and then the feel of the fruit without the skin on, the look of the fruit with its segments and the white stringy bits, the juice.  While eating it I noticed not just the flavour, but the texture in my mouth and the sensation of swallowing.  I paid attention to the sticky juice on my fingers and the sweet smell that it left on my skin before I washed my hands.  The idea was to be fully in the moment and to engage and experience all of the senses.  To be mindfully – deliberately into eating that mandarin.

The breathing exercises

After learning about the need to experience the full extent of whatever I was doing, I did some breathing exercises with my Psychologist.  The idea was not to control the breath, but to observe it – pay attention to the movement of my muscles, the sensation of the air in my body, the sounds of the breath and to concentrate my focus on that.  If I was distracted, I would just think to myself “oh, I’m distracted” – or whatever – and return my attention to the breathing.  It was hard not to start controlling the breathing – but relaxing.  It took focus, but was refreshing and left me alert.

My homework was to practice this and I also had an exercise where I was to start out with the breathing exercises and then imagine the breath that I was inhaling circulating all the way to my toes and paying attention to my toes and then following my breath as I exhaled.  From here attention moved, with my breathing, progressively from the toes to the feet, up the legs, along the other leg and then through my body and my hands, my head and back to just focusing on my lungs.  If you have ever done progressive muscle relaxation, the process is similar – however this was more to do with gradually moving awareness through the body.  Again, the instructions were to allow yourself to just dismiss distraction and go back to the exercise at hand.  I also felt more self-aware and awake after the exercise.  That one lasted about 15 mins.

The Wii game

There is a game on Wii Fit where you have to sit really still.  The graphic on the screen is of a candle and from time to time you get annoying things like a fly or mozzie and footsteps and so forth that come to distract you.  But you need to sit upright and still on the balance board for 2 mins to win the game.

I have found that this is a great exercise for my Mindfulness skills.  I sit in an alert and comfortable posture.  I focus on my breathing and I use my skills that dismiss distractions by acknowledging that they are there and accepting it to deal with the insects and so forth.  I can sit for the whole 2 minutes using my Mindfulness skills!

The fly

A while ago I was staining a piece of furniture.  I needed one hand to hold the tin of wood stain.  I was using an elbow and shoulder to stabilise myself in the most awkward position ever (!!).  The other hand was occupied with cloth working the stain into the grain of the wood.  And there was a fly buzzing in my face throughout.

Now, the same way that you consciously turn all of your senses, you may choose not to do so with some – so I am not focusing upon the fumes.  But again, with the discipline to focus on the here and now and what I want and is important, I can also notice and dismiss what I don’t want.  The fumes.  More particularly in this instance, the fly that just wouldn’t go away.  Rather than let it get me irritated and waste all that energy, the practice allowed me to focus on my work and when the fly was distracting just acknowledge “There’s that fly again.  That buzzing is loud.  I wish it would go away.”  Yes I would blow at it to try to discourage it – but no, I managed to deal with the fly without it driving me mad.  I considered this to be an achievement!

The job interview

I had a job interview at the other end of town.  I had a horrible time getting there.  There was more traffic than I anticipated, I think the tail end of a blockage after there had been a prang.  Plus I had been pushing the clock harder than I had wanted to be to start with.  The end result was that I was late to my job interview.

Bad news.

I was so flustered by the time that I got there that I couldn’t think.  My mind was pumping in circles.  They handed me the interview question for my preparation and all I could do was think,

“How am I going to pull together to do this?”

So I stopped myself.  And before I even looked at the questions I took 2 minutes out of my prep time to do my breathing exercises.  I then gradually brought myself back into awareness of the room around me and focused on the task at hand.  I was alert.  I was focused on the task and I was calm.  I had also put myself into a position that I could acknowledge that the situation was less than ideal and just accept it to focus on what I could do something about.  I could have compassion on myself for finding myself in an embarrassing situation, yet function within it and set myself to do my best in the here and now.  I prepped my questions briefly in what time I had left although I didn’t have time for much depth and then did the interview – again thinking clearly, because I was able to focus on the here and now.

In the end I think the fact that I pulled myself together worked in my favour.  I was offered the job, but turned it down.  Mindfulness got me through the job interview but it would not get me over the travelling time in peak hour traffic any quicker.

The terrible, no good, very bad day

Then there was the day that nothing went right.  Well it seemed like it.  I slept through my alarm.  Right through.  Things went wrong at home after I got up.  The trip in was slow.  I was very, very, very late for work.  Lunch time late.  I missed several appointments and was flustered about what was left of the day.  I had no idea how I was going to finish the day or face anyone.  After freaking out when I finally got to work, I finally stopped and thought, “I know better than this.”

So I paused.  I took a deep breath in and let it out, focused my attention and started observing my breathing.  I then started to pay attention to the feel of the pressure of the chair that I was sitting in and the sounds around me – not listening, just noticing – the clock, various voices, footsteps; I paid attention to the feel of the clothes on my skin and then turned my attention to my muscles and which ones were tense.  I relaxed my shoulders and my jaw and went back to my breathing and did a short version of the breathing exercise where I imagined my breath reaching every part of my body and then just focused on how it felt to breathe for a couple of moments.

After this I allowed myself to think about what I should do next.  I had to accept that I was late and that I’d missed morning appointments and that because of that my afternoon wasn’t going to work as well as I had planned.  But I could now, thinking in the moment accept that just as it was and act in a manner that was compassionate toward myself, rather than sit there blaming myself for things that I might or might not have done.  It was okay that I was a bit frazzled, that was understandable – so I just needed to plan for that too.  From there I was able to return to the moment and begin the rest of my day, planning things out and actually achieved a reasonable amount – something I wouldn’t have done in the state of mind I had been in when I arrived.

The road so far …

It has taken a while to learn some of the basics of Mindfulness and get used to putting them into practice, but the journey has been infinitely worthwhile.  I still have a long way to go.  I’m not good at meditation –  I tend to be more utilitarian in my use of it.  I still need to remind myself to start and could prevent some situations by starting earlier.  However, it helps me to focus and to be able to be where I am, doing what I need to or want to be doing at the moment of time that I’m at.  My next step in the journey is to become better at noticing things about myself in the moment.  I think that this would prevent a lot of difficult situations and to help me to monitor my early warning signs.

 

Watching Wellth 16/10/2011

The journey’s oft’ rough as one travels the road

with one’s mood apt to upset the cart;

And if climbing back on aft’ one spill weren’t enough –

Alas – staying on top is an art!

For most of us who have passed though one episode of depression – or other forms of mental illness and come out the other side, a common concern draws us.  We don’t want to go back there.

Some have a harder battle ahead of them than others.  Some have different forms of depression; different forms of anxiety; different forms of mental illness that are more or less responsive to the things that we do to treat them.  Some are more vigilant than others – often this makes a big difference … and sometimes life’s not fair.  Some do all the ‘wrong’ things and yet never have another episode – but that’s unusual.

What’s usual is hard work with a need to use a range of strategies to stay well.  Things like good sleep, exercise, a nutritious diet, keeping up social support networks and getting out of the house, exposure to sunlight and fresh air, use of medications and talking therapies are just some examples of these.

But how do we know that we’re winning?  What can we do at the times when we’re worried about how our mood is going to try to prevent it from tipping over the edge into something we can’t manage?  How do we know if that new medication is doing anything to change anything at all?

One of the things that is helpful to do at times is to track your mood.  How do you do this?  You use a mood diary.  Ever done it?

The purpose of a mood diary is essentially to get a profile of what pattern your mood is following on a day-to-day basis.  At their most basic level, a mood diary will ask you to rate your mood on a numerical or incremental scale every day while you keep it.  Some will additionally ask you to record other information such as your anxiety levels, your irritability levels, how much sleep you had the night before, significant events and triggers throughout the day and/or the medication that you took.  The good thing about doing some of these other things is that they provide a much fuller picture of what is going on.

If you don’t already know what they are – this process can help you to work out what your early warning signs are as well as your triggers.  If you know your triggers and early warning signs, this can help you to monitor them. For that reason, I recommend choosing a mood diary that records significant events in the day.  I would also recommend one that includes the amount of sleep that you had the night before as this tends to be pretty universal and fairly influential.

Talk to someone close and ask for their help if you have trouble working out if you were irritable or if they noticed anything in particular that seemed to set you off if you are having trouble identifying these kinds of things – but the object of the exercise is to make observations about yourself – so do what you can on your own as well.

However, asking someone close to you whom you trust to help monitor your mood and to help you get to know your warning signs and triggers is a good strategy.  They sometimes see things that you are not in the right place to see or notice when you’re not well because your self-awareness can get a bit skewed.  They also see the ways that you differ from the way that you would normally be – so they can measure you against you and not somebody else.  Yes, it might be their perception – but it will still be your behaviour and actions and the things that you say and the responses and facial expressions that they are used to that are part of you.  Choose someone who you trust and talk with them and let them tell you about what they noticed changing last time and as you have been working through your recovery.

Do I use a mood diary and self monitoring systems all of the time?

Not on a daily basis.  When I am well I keep regular tabs on how I am going by talking about it with a good friend and checking over my early warning signs and triggers list regularly to ensure that my awareness of them is good and that I am alert to high risk periods.  I use what is called a WRAP – a Wellness Recovery Action Plan where I have identified what I am like when well, what my triggers are, what things are hints that I’m not as good as I could be, my early warning signs and so on …. I go through this regularly.  Some people do monitor their mood daily and find that it works well for them.  People with things like rapid cycling Bipolar disorder often find that they need to until it slows down and is brought under control.  At first I needed to chart my mood a lot more than I do now.

When I am in a high risk period I watch things more closely and have recently resolved to keep a mood diary through high risk periods because I still find myself at sea sometimes and feeling like I’m losing my grip.  I am particularly vigilant about my warning signs and triggers as well as their corresponding action plans during periods of high risk.  I have to be.  Recently I let things go at home and let the dishes and the housework pile up around me – a sign that things are getting away from me and didn’t act and it triggered me (it becomes a cycle).  I couldn’t face getting up to look at the house.  I didn’t want to go into the kitchen to prepare a decent meal because it was a mess and I didn’t feel up to cleaning it up – so of course my nutrition level went down, my budget blew out and thus the cycle continued.  In the end it took a cleaning weekend to put me back on track, followed by a week of very early nights and a lot  of discipline.  It’s too easy.  So I have decided that I need to do something to catch myself more quickly before it gets away from me.  Not simply cleaning, just lots of little things.  This time of year I need to be very careful about relapse prevention.  It sounds minor when I talk about dishes – but when it snowballs, I just keep sleeping and if I sleep through work or go in late consistently and am still going around in circles while I’m at work and don’t have energy or concentration to work – I could lose my job.

I’ve attached today some links to some self monitoring resources and different mood diary sites.  I know there’s a lot, but different things suit different people and I think these are important tools.  Most mood diaries have room for the full spectrum of mood disorders – both mania and depression.

Warning signs and triggers are important.  Monitoring your mood is tedious sometimes – but there are times when it is necessary.

General

http://breeze.blackdoginstitute.org.au/keepingwell/

Mood Diaries

http://www.bipolar.com.au/common/pdf/mood-diary.pdf

http://www.blackdoginstitute.org.au/docs/MoodChartforDepressionandhowtomonitoryourprogress.pdf

http://www.blackdoginstitute.org.au/docs/DailyRatingScale.pdf
http://www.psychiatry24x7.com/bgdisplay.jhtml?itemname=mooddiary

http://www.moodscope.com/ for those who like online resources

https://www.moodtracker.com/ another online resource

http://itunes.apple.com/au/app/moody-me-mood-diary-tracker/id411567371?mt=8 for those who like apps

Mood Monitoring & Relapse Prevention Programmes

http://www.cci.health.wa.gov.au/docs/KYB-3-Self%20Monitoring.pdf

http://www.idamaecampbell.org/files/40263519.pdf (WRAP personal workbook)

Early Warning Signs

http://www.health.qld.gov.au/rbwh/docs/early_warming_signs.pdf

http://www.blackdoginstitute.org.au/docs/20.WellbeingPlanforBipolarDisorder.pdf (can be used for depression too)

Healthy Lifestyle

https://www.mindbodylife.com.au/Downloads/index.cfm

 

 

 

 
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