livingwithablackdog

sit. stay. good boy.

The Wall with a Hole in it … 30/09/2011

And I’m not talking ATM.
Have you ever felt yourself to be up against that dragon that you were never destined to slay?  That worm you’ll never be early enough to get? The one that leaves you feeling like the Emperor in all his glory when he set out in grand style to show off his ‘new clothes’ just when you think you’ve gotten a hold on it.

My nemesis is time.  Not just any time – although we have a slippery time keeping pace with each other continually.  No, the ultimate battle is drawn around the time of sleep and waking.  Here I am repeatedly mauled by my dragon, eaten by the worm and left with nothing but the Emperor’s new clothes to show for all the effort that I have made to conquer the struggle.  I feel as though I am beating my head against a brick wall.

What happens you ask?

I set an alarm clock.  Actually I set two alarm clocks ten minutes apart.  I do not trust myself with one.  I have been known to turn one off in my sleep!  I set one to raise my level of consciousness and the other to wake me.  For most of the year this is adequate.  But then comes the changing of the guard – it starts to get light earlier or later in the spring or autumn and for several weeks my dog hides the alarm clocks.  He must.  Some nights anyway – because they sure as hell don’t wake me.  But then I also have trouble in getting to sleep – so maybe it’s not all the dog’s fault.  At times I sleep no more than an hour or two a night.  Others I may get to sleep and then wake up at two in the afternoon – ON A WORK DAY!  This year I thought that I was winning at work until the seasonal sleep monster set in.

Right now I feel like I am beating my head against a brick clock.  In getting to sleep.  In waking up.  In getting to work.  My psychiatrist has given me something to try for the short-term (ie 4-6 weeks) as it’s a regular pattern and struggle and part of a bigger picture of short-term seasonal change in my mood.  It’s not a relapse – just a dip.  But oh so disappointing because its been so stable for so long.  In lots of ways I think I could handle it if the sleep didn’t go out the window.  It’s started to affect my work though, so I’m taking the medical option this time.  Maybe next time I’ll be able to have the personal strategies down strongly enough to manage it without boosting my meds for a few weeks – but I need to prioritise keeping my job over my pride for this time.  I may have to wake up and phone in to work in the Emperor’s new clothes.  I do not have to parade through the streets in them.

Bloody Dog.

Damn Clock.

So for now I get my sleep under control.  I keep my mood stable with a little extra help than usual until the season settles.  At least I will be able to keep the dog in his place.  At least I will stop messing things up so badly in getting to work.  It will only be for a few weeks and then its back to the normal cocktail that I’ve accepted will be a part of everyday.  Back to using my ‘personal medicine’ or lifestyle strategies to manage life and its stressors.  Then I get summer to strengthen my other skills and to be ready for autumn when it comes.  Perhaps I will plan a short increase in meds again.  Perhaps I will plan time off work.  Perhaps I will be enough on top of my sleep to manage it with flying colours.

My Dog loves the twilight of the seasons.  He thinks its play time.  He loves the dawn.  He dances while I wake.

Oh to be able to open one eye and say in my firmest voice.

“Sit. Dog.  Sit!”

And have confidence that he’d obey.

One day.  One day he will.  One day I am determined to slay that dragon.

One day.

 

Seasons Come & Seasons Go 29/09/2011

Some people are Summer people.  Some people, spring people.  Some are winter people.  Some love autumn.

No, I’m not talking about people’s colouring or the things that they like to wear (that is something that I, in fact know very little about).  I am simply talking about peoples’ favourite times of year.  Some people like to soak up the sunshine in summery garb out in the garden, down at the beach or over at the local pool.  Others love to curl up by the fire in their favourite jumper under a rug with a good book and a cup of hot chocolate – or put a movie on.  Some love the colours of autumn and the beginnings of that lick of ice in the early evening.  And some the radiant brightness of spring, its scents, the new life, the slow steady warmth, the magpies diving at you from overhead…

I never settled to a favourite time of year.  I really do enjoy almost all of all seasons – and by the time one ends I am ready for the next.  I am not fond of the days that exceed 40 degrees celsius with no cool breeze for long stretches at a time.  Hot winds are their own breed of evil in Australia for reasons far beyond temperature tolerance.  I’m not a great fan of temperatures at the other end of the spectrum either – especially if they come with a wind.  Actually – wind bugs me more than temperature.  But seasons – apart from the odd bits like getting up in the dark to go to work in winter – seasons are a delight.  Full of life.  At least, I always used to think so.

My dog pays attention to the seasons too.

Unlike me, the dog has clear preferences for different times of the year.  It took me a while to work this out, but its consistent.  The dog is stubborn in winter.  He moves slow.  He needs more time.  He takes more time and holds me up whether I plan it or not and he wears me out more easily than he does during the warmer months.  I think he’s arthritic.  He gives me no trouble if I allow for the arthritis though.  A bit more sleep – 1/2 hr or so more than I need in summer and I’m fine.  I just need to be patient.

Summer is usually the dog’s best time of year.  He still needs discipline, but he’s more content to walk at heel and doesn’t drag and tug away at the lead.  Spring and Autumn are strange.  Most of the seasons fall in with the winter and summer behaviour for Dog according to temperature and what the light is doing.  In each of these season there comes a point where the light changes – and over these few weeks the dog goes nuts.  He is unpredictable.  I can not afford to let my guard down for more than a few moments at a time.  My sleep gets poor – this starts the ball rolling.  My energy levels become low, my motivation to maintain routine relapse prevention strategies gets sloppy and I soooo don’t feel like doing anything about it.  It at these times that I have frequently relapsed (almost without exception).  I made it through autumn this year.  So far I have struggled this far through the last few weeks.  Another 3 – 4 should see me through the worst of it.

Until then, its keep on keeping on and stick to the programme.  Watch for warning signs – the very time of year in and of itself is a trigger – even without the presence of other factors.  Light does funny things to my health in other areas too.  It’s like the dog becomes delirious.  Here is a time when I need my friends and family – my supports more than any other time of the year.  I’m struggling to get to work on time at the moment, but so far my boss has let me cover with time in lieu.  Still, I’m determined to conquer that one too.  I get there on time more often than not – just not as often as I should.  Just now – when I least feel like it – discipline becomes oh so important.

I had my last review with my Psychiatrist this week.  We agreed that it would also be possibly a beneficial thing to increase one of my medications for 1-2 months during the peak risk zone while I’m wrestling risk factors and wavering – just for that short-term – and then go back to my current dose afterwards as the weather and season stabilises a bit more.

Hopefully the combination of ‘personal medicine’ or monitoring of triggers and early warning signs with the kind of action plans that are outlined in my post “Better Medicine”  with the temporary medication adjustment will prove to be a good protective measure.  I’ve had a good year.  I’d hate to mess it up now.  I’m hoping to get to at least a whole year without a relapse this year!

So roll on to the latter end of Spring.  Because despite all of this, I really do love spring.  There’s a certain level of hope and promise in the air in Spring that’s unique to this time of year.

Come Dog.  Heel.  Walk.  Heel.  Walk.  Heel …

 

Food Glorious Food 25/09/2011

Fruit.  Vegetables.  Meat.  Protein.  Dairy. Iron.  Carbohydrates.  Breads.  Cereals. Rice. Pasta.  Vitamin E.  Vitamin C.  Vitamin D. Vitamin B.  Fats.  Sugar.  Cholesterol.
Hormones.  Blood Sugar levels.  Chocolate.  Shortbread…

How we eat makes a big difference to how we feel.  It affects how much energy we have.  It affects how efficiently our system processes what we do eat and how easily it will break down and prevent or minimise constipation.  For some it can affect them at a more vital level – for those with diabetes it is even more important to monitor food intake, as for those with particular allergies.

Recent studies indicated that people with depression have a high (anything up to a one in two) risk of developing diabetes.  That is an enormously scarily high statistic.  You might ask, “Why?  Why this on top of everything else?”

A large part of the answer is thought to be tied up in lifestyle issues.  They actually think that for most people this is preventable!  Risk factors for development of type 2 diabetes include lack of exercise and sedentary lifestyle (ie sitting around a lot and inactive), obesity especially if your weight distribution is more around your stomach than your hips and thighs, eating unhealthily is a major cause of type 2 diabetes – too much fat, too many simple carbohydrates and not enough fibre in particular; also high blood pressure, high cholesterol levels, high cortisol (stress hormone) levels,  smoking, family history, gestational diabetes and aging (over age 45 becomes higher risk).

A lot of these risk factors overlap with issues that occur regularly in people with depression.  It is common for people with depression to have little physical exercise and very sedentary lifestyles, poor diet and become overweight due to a combination of this and at times side effects of medications – and the lovely little belly that the medication leaves is usually a tummy rather than hips and thighs.  Stress level hormone levels may be high due to anxiety levels; depression, like diabetes often has genetic links, many of the high levels can be secondary to diet and lack of exercise and statistics indicate that a high proportion of people with depression also smoke.  Oh – and yes, we might say that we’re 39 for a while, but everybody ages.

The good news is that the majority of the factors identified as risks are preventable.  They are also helpful ways to improve the prognosis of the course of our mental health.

Look for ways to become more active.  Start small and build up a little at a time.  Sooner or later you will feel like you are exercising.  In the meantime, you will be stretching out those muscles and getting them ready for a challenge.  One of the biggest weight loss programmes in the world was started by a woman who started out by walking around her clothesline.

Research what needs to go into a balanced diet.  Plan what you will eat ahead of time and stick to it.  I find this really hard, but it really is worth it.  I have more energy when I do and it helps keep a lot of other things more balanced.  Try cutting up your veggies when you get them and storing them ready to use – that way you don’t have as much to do to prepare food when you have to cook.  Same with your meat and everything else.  It takes longer to store – but half the time (at least for me) a large part of the battle in getting the energy together to get something healthy and wholesome to eat is in overcoming that ‘I don’t feel like all the preparation’ feeling.  At worst keep a couple of pre-cooked healthy meals stored in the freezer for when you don’t feel like cooking.

Talk to your doctor about a Quit smoking programme.  It is possible.  People do it all the time.

See someone about some anxiety management strategies.  If you already see a case worker, therapist or doctor ask them for advice about what to do or where to go.  Look around for local programmes through community health resources.  If you get stuck and are not sure where to start, check out the mindfulness and CBT pages on this site or post me a comment and let me know.  If you’re in Australia, ask your GP to write you a referral under “Better Health” to see a psychologist or clinical psychologist.

Just to start off, this week I had a really simple meal of a piece of steak about the size of the palm of my hand.  I had a couple of mushrooms that I chopped up and cooked with it in the pan.  I then steamed in the microwave generous serves of broccoli, cauliflower, both green beans and yellow ones and some snow peas that I grew in my garden.  It was filling, plain and simple.

Why not share something healthy that you cook/prepare or plan to cook/prepare after reading this in the comments.  Maybe we can collect some recipes and ideas?

 

I wanna be a … 18/09/2011

Jetson!

Are you old enough to know The Jetsons, I wonder?  Most are, surely.

I’m not after the groovy little space-sedan.

I’m not even in it so much for the robot house keeper – although I would certainly NOT turn her away …

I want the bed that tips you out when you need to get up, stands you up and puts you on a conveyor belt to the shower and gets you started for the day.

I swear, that has got to be the hardest part of the day!  I’m okay once I’m showered and dressed for the day – but until that point it is all up hill.

On work days I don’t trust myself with less than two alarm clocks.  I’ve been known to turn alarm clocks off in my sleep.  I figure that one will at least bring me out of deep sleep and the second can wake me if the first doesn’t.  I don’t keep at least one near my bed.  I make sure that I need to touch floor to turn it off.  I also make sure it’s a really noxious sound so that I don’t just let it keep going.

One thing that I don’t do that a lot of people say works well for them is put out my clothes the night before.  I have tried it a few times, but tend to finish up thinking that I don’t feel like wearing what I put out and finish up dithering over what I do want to wear.  That said – it would probably work fine on work days if I kept it up – so I should try it again.

I also tend to waste a lot of time putting off getting to the shower (especially in winter) puttering around the house.  Alas! This just makes me late.

Oh for an alarm clock that tipped the mattress 45 degrees and dumped me on the floor with a bang if I reached for a snooze button!

Drat the need for motivation, will power, decent routine & bedtimes, discipline in lights out and organisation in the morning.

But then again, if I have been eating well, doing exercise, working, and going to bed at a decent hour I am likely to have been refreshed by sleep and find it easier (note that the word here is “easier” and NOT necessarily “easy”) to wake and rise.  Perhaps key to my struggle with rising in the mornings is my lack of discipline in other areas – most obviously in getting to bed at a decent hour reliably, but also exercising regularly.  I would also have more energy if my diet included more fruit and vegetables.

So many things to fine tune.

I still envy George Jetson.

 

My Pyjamas 07/09/2011

I know better.  I really, really do.  There are good reasons why it’s not uncommon to find me in my pyjamas long after I get up.  Really …

Firstly they are comfortable.  Soft fabric, loose, warm, cosy.  In summer soft and breezy.

They’re warm (it’s still cool down here in the Southern hemisphere)

I’d need to take them off and be unwarm for a little while to get dressed.

I don’t feel like having a shower and all that yet (today is my day off).  Too much effort.

I’m not sure what I want to wear later today and am not that motivated to choose at the moment because it really doesn’t matter.

I’m at home.

They’re home and relaxing kind of feeling things.

Nobody else is going to see me.

I LIKE my pyjamas!

It saves washing???

Smell? What smell? …  ohh! you mean the one that’s following me when I do this for three days in a row without changing?

But that’s not me today.  Today’s my day off.  Lots of people mooch around in their PJs late into the morning on their day off.  Yet, only last week I was recalling that this behaviour – when habitual is one of my warning signs.How do I know the difference?  In truth – I don’t.  At least, I’ve missed the warning signs until too late enough times that I know that I’m not yet able to reliably spot the difference.  What can I do?

The first option is to not let myself stay in my PJs after getting up whatever the day – rather to go straight for the shower or get dressed as soon as I get up.  Reality is that I don’t really put a serious start to the day while I’m still in my PJs – and I need to move past the ‘getting up’ phase of the day earlier than I do much of the time.

The second is that I time limit it and say that I need to be out of my PJs by a certain time.  I’m thinking of taking this one up.  Which means the next thing that I need to do is head for the shower because it has passed that time already.

Wish me luck.

 

Attishoo! Attishoo! We All Fall Down 31/08/2011

What’s going on?

I’ve got a headache that I’ve had on and off for a few days now.  I’m so tired so much of the time.  I’m disorganised.  My house is a mess and getting less clean than I’d like it to be – it’s not grotty, but without action it could get there without a lot of effort … I’ve spent the last couple of days off loafing in my ever comfy PJs and while I’ve gotten up and done stuff, I’m sure I said ages ago that I was going to stop doing that…

Hang on.  These things are all among my early warning signs.  I’m off my game.  Nothing serious yet – but now is the time to act.  I’ve been going really well for ages.  It’s not even my Depression that’s knocked me off my game – it’s the damn cold that I’ve been fighting.  Yet this I do know.  In the past relapse has often followed physical illness.  The dog acts when he knows I’m not at my best.  He takes advantage of weakness.

So what do I do now?  Give in? Panic?  Book an extra doctor’s appointment?  Nope.  Now is the time to reach for my WRAP – my Wellness Recovery Action Plan – something that I should probably be going over more regularly to remind myself of the daily and weekly/regular things that keep me well.  In my WRAP I found that I’ve been neglecting a lot of these over the last couple of weeks and that I have gotten sloppy with a couple of my routine maintenance markers over the past couple of months.  My work WRAP (my own experiment) shows me that I’ve not been sticking to my wellness goals about leaving on time and planning my day either – no wonder I’ve been feeling like I’ve been run over by a truck.

Now is the time to restart the action plans.  I need to tell someone that I’ve noticed that I’m off my game and that I’m acting on it – that way they can ask me how I am going with my action plan in a couple of days to see if I need some help to get things moving again or if I’ve been able to self-start again solo (often harder than I think it’s going to be).  I’ll wait to see how things progress and talk it over with my friend before I rush into moving any appointments forward.  I think I’m okay if I get reorganised at this point.

So its back to setting alarms and keeping them for going to bed and lights out at night.  I’ve been letting the sleep run thin.

I need to plan my meals rather than look in the fridge and hope that there’s something I feel like eating in there.  And I probably need to start putting more attention towards the balance of what I eat because I don’t think I’m eating enough fresh fruit and vegetables (that’s a new strand to the plan for me).

I need to put away the things that are lying around and creating clutter.

I need to clean the house.  When that goes to my list though it will read room by room and the floors will be separate.  That way I can do it in parts and feel like I’m making headway when I cross things off on my list.

I need to set up a routine for maintaining my housework.

I need to set aside time for doing things that I like to do.

I need to work out how I want to prioritise a couple of things that I have going at the moment so that I can put away what I am not going to finish in the immediate future and finish off what I am doing in my ‘projects’ department.

I need to set aside time for some meditation and prayer.

I need to make sure I leave work on time.

I need to make better use of my diary and go back to keeping a list of things that I need to do to mark off and prioritise – this works well for me

I also really need to put some effort into starting to exercise and to spending more time outdoors.

If I need help with anything, I can and will ask.

I’ve been good with most of my other stuff but things involving routine, and doing things that I’m not instinctively motivated by (like exercise and cooking for anything other than guests) are difficult.  It may get easier.  Who knows?  My goal is to find something that I enjoy in the things that I find difficult to do at some point – but not now.  Now the need is to just do it.

We all fall down.  We all need to know the best way to get up again too.  Take the time to be prepared.  I use the WRAP (http://www.mentalhealthrecovery.com/wrap/ .  You can now download an old edition of this from “Recovery X-Change” http://www.recoveryxchange.org/downloads/RxChange%20WRAP%20WorkBook.pdf  if you want to check it out a bit more closely).  There are a number of different systems people have.  The most important thing is to be ready to be ready.

All I have is a cold.  It does not have to become a relapse.

Right now though it’s approaching bed time.  So rather than editing anything else.  I’m going to post this and head for the sack.  Good night.

 

The Best Bucket For Fishing In 27/08/2011

I have been cleaning out my study over the last couple of days – no small job – I have been putting it off for a long time.  I unearthed a lot of rubbish, a tonne of reading, receipts, filing, thankfully nothing that should have been included in my tax (which I have done already this year – yay me!) and my bucket list that I did for my Psychologist earlier in the year.

Why a bucket list?

I had been depressed on and off for years.  When I was well I had only just been coping with no room for anything but putting one foot in front of the other.  It had been a long time since I had really allowed myself to cast my eyes very far into the future.  It was hard to do.  My life had become so tied up in looking after the dog and keeping him out of the way so that I could manage walking that it was hard to picture anything else.  This is not a healthy way to live!

Maybe not – but everyone knows that we need to get through each day – so what’s the point of looking any further?

My first response to this would be to give you a reason to stick to the fundamentals that feel so arduous when times are tough.  The healthy lifestyle, the sleep, the medication, the self management strategies that you’ve chosen to compliment your medical treatment (see my post Beyond Medicine) can feel like such a chore at times, and there are days when you question if your daily struggles are all that important.  Things that have some value and potential to motivate you are important.

My second is that a routine is strongly recommended, but often hard to fill out.  An exercise like doing a bucket list may give some clues to your interests or things that you could start even now to use time doing something that you are more likely to consider worthwhile.

Thirdly, if you are getting well and your health is stable, but you’re a bit lost about what you want to do – this is a great way to brainstorm ideas that you can later use to figure out what direction you want to work towards and what sort of goals you want to set for yourself.  You can also look at the different sort of things you have put on your list and use it to try to make sure you keep some balance to your goals so that you can target a balanced lifestyle that reflects you.

Fourthly, if you are struggling to stay well and all that you are focussing on your health or perhaps your health and keeping your job – perhaps you can use it to choose one thing to help with relaxation and/or re-energising.  Often – and I speak from several years of experience here – this is neglected to our detriment when expanding our support network and finding opportunities elsewhere for success would improve our workplace performance and keep the dog in his place much more effectively.

Not sure what you’d put on it?  Try meeting up with a friend and do bucket lists together (I met up with a couple of different people).  This helps stretch your ideas until you start freeing up your mind.  Read past journals if you have some if you used to write about things you’d like to do one day.  Be as vague or specific as you like – it’s your list.

Here are some of the things on my list:

Bushwalking

Make a pretty garden

Redo a house

Teach professional practice skills

Overcome Depression and Anxiety to the point where they no longer require any intervention – even meds

Stay well

To make sure I keep up friendships and make new ones

To grow wise but be humble

To be physically fit and able to run without getting puffed out

To get good at being organised and reliable

To learn lots of interesting things eg Ancient Greek, Ancient & modern History, Latin, Languages, Leadlighting, Aromatherapy, Sciences, making things, gardening, writing and publication industry, professional development and research, theology …

Write a book and publish it

Write a children’s book, get it illustrated and publish it

Go to Scotland, Ireland and Canada and see lots of other places too

Learn Piano

Write a song

Learn to play Cello and/or an alto/tenor woodwind instrument

Research and develop useful intervention strategy for use in Mental Health Recovery – meaningful to and valued by consumers – well weighted by evidence

Learn to tap dance

Build a doll house

Act in a stage performance

There’s a tonne of others that I’m not going to share and I’ve simplified a lot of these.  But they have made way for goals and routine and positive steps.

There are six major themes among the things in my bucket:

Creativity

Learning

Relationships

Social Responsibility/contributing to others

Travel/adventure

Growth (language, fitness etc)

My challenge is to have something – one thing at a time among my goals that touches on each of these areas.  I also try to include something of each – at least most – in my routine.

The steps to some dreams are appealing.  The way to others not so much.  The keys are choice, balance and timing.

Never let the dog stop you from dreaming.  Sure, be careful not to get stuck in them – but be careful not to lose sight of the things that you’d like to do or some day.  These are the things that give you a reason to put your next foot forward.  These are the things that make it matter that the dog stays out of your path.  These are the things that help you choose which direction you walk in.  These are the things that make it matter that it’s you and not the dog that does the choosing.

Look where you are going.  Move deliberately.  Walk one step at a time if you must during the hard times, catching your balance and calling the dog back to heel in between.   Don’t let him draw you down to wrestle with him while you walk.  When you stop looking where you are going, the dog has the upper paw.  Shorten the leash.  Keep him close.  Don’t give him an inch.

Heel, Dog.  Heel!

 

When the Mallee Bull’s Away … 24/08/2011

In recent years I have developed a fierce respect for my health.  Not only my mental health – but my physical health.  Whereas before I had little patience for the times when I was sick, there are times now when I fear it.  When I am sick I just use more sick days at work – which raises more questions and more suspicion: “what is really going on?”.  I feel disgusting.  I break all of my carefully laid down routines and maintenance plans.  I have to take more tablets. And all too often it drags on for too long thanks to poor immunity and a system that’s already struggling with every day and brings me – if not to relapse, then certainly to the brink.

When I am sick, the dog often thinks he is allowed to play.

It makes sense.  There is less energy to be on top of my game with my thinking, so if I’m not ultra careful I do forget to reality test my thoughts.  I get lazy and don’t practice mindfulness.  My appetite is lacking, so unless there is someone else cooking for me and serving up nutritious food, I’m not eating well.  I’m exhausted and sleeping all the time and not maintaining my routine.  I’m too sick to exercise.  My medication is going in – but that’s about the only maintenance activity that is actually happening – and if I have a gastro bug even that gets out of kilter.

Short term bugs aren’t so bad.  A day or two and I get back on top of my game without too many problems.  No, the one that I hate most of all is surprising to some people.  The thing I dread most is the common cold.  It drags on forever.  It saps my energy.  It robs me of the desire to prepare decent food, to look after the house, to keep much of a routine.  Sound like anything else you know?  I live in fear that the head cold will go to my chest and then I will finish up coughing for weeks on end which leads to fear of aggravation of an old back injury – and so my thoughts become dominated by dismal and negative themes and the black dog leaves his rightful position at heel and begins to circle again.  Thus it is that I find that a cold, if I can’t get rid of it quickly can be a trigger for relapse.

So – what do I do?  I stay rested.  I eat well.  I have my flu shots – which I know some find controversial – and that there are also people who are not convinced that this helps, but as a health worker I find that it has left me less vulnerable and in Australia health workers get them for free.  I wash my hands regularly and use hand disinfectant.  I dress to the climate.  I’ve given up rain walks in cold weather.  Some people use vitamins, but to be honest I couldn’t face taking any more pills and don’t want to spend the money and would rather just eat the vegetables.  I try to avoid spending a lot of time with people who are sick.  If you look back a couple of posts to ‘Beyond Medicine‘, you will find that these are the things that will keep you physically healthy as well as mentally healthy.  If you want to keep the bugs at bay these are the things you go to.  Some I have already mentioned, but lifestyle habits and strategies that reduce stress are also important.  Support is important.  Hope is important.  Sunshine is important.  Recognising the early warning signs and triggers of physical illness is important.  Our mental health and physical health are inextricably linked.

If I get a cold, I do start taking cold and flu tablets early when I get symptoms of a cold – particularly at night, and I use airway clearing aromatherapy oil before I go to sleep so that I can breathe clearly.  I also sleep propped up slightly.  Usually these things stop the cold from getting to my chest.  Usually.

This year has gone well so far.  I’ve stayed mentally well enough while I’ve been sick that I’ve still been able to use my mindfulness and cognitive behavioural techniques to keep the dog in line, so he hasn’t really challenged – even when some of the other important stuff has fallen by the wayside.  It’s still going to involve work to get the rest back in place, but hopefully not as much as usual.  So just for the moment while I get a bit better…

Sit, Dog… Sit.

 

Planning with Purpose 21/08/2011

In my last entry I wrote about going back to work.  I also made brief reference to having a need for some kind of productive activity if I wasn’t.  One of my regular readers made a comment that spoke directly to something really important.  The need for purposeful activity.  Not necessarily work – but activity that is goal directed and meaningful to you.  Activity in which you are setting out to achieve something that you are interested in achieving.  It doesn’t need to be paid activity, but it needs to provide you with a sense of purpose and achievement.  This reader suggested that – but for the expense of living, she would not even care so much about paid work as long as she had purposeful activity.  I have to say that I agree.  Sound odd?  It’s one of the biggest problems people have when they retire.  Not having planned for their need for purposeful activity.
The thing is – people have an innate need to do something.  Preferably something they value and something that is purposeful.  All you have to listen to one of the things that we complain about.
“I’m bored”, “There’s nothing to do”
“What’s the point of this?”, “This is a waste of time!”, “I hate doing this.”, “I’d rather …”, “I’m sick of doing this”, “None of this does anyone any good”
“When am I ever going to use this?”, “No-one’s going to look at it …”, “All I did was sit and look at the …”
Examination of research into the presentation of people with long-term unemployment and people with Depression actually show a lot of similarities.  Things like loss of routine, beginning to neglect personal appearance, poor diet, lack of activity, sedentary lifestyle, poor sleep habits, loss of motivation, social isolation, loss of self-esteem …
Of course for many there are possibly crossover elements of situational depression, however it is interesting to note that the lack of purposeful activity can have such a strong effect.  A study that I heard presented followed up some people some of whom pursued work – some full-time, some part-time; some of whom pursued volunteering.  The outcome – purposeful activity made an enormous difference to quality of life.
But other studies show that it does not even need to be work related.  Simply valued and purposeful – and it will improve quality of life and wellness.  Take up gardening.  Build a doll house for a kid.  Join a gym or walk somewhere every day.  Volunteer at a local charity, Church or club.  Write a book.  Go to a local community centre and check out the programme.  Do a course on something that interests you.  Join a book club.  Start meeting a friend for coffee regularly.  Take up cooking.  Invite a friend over for dinner.  Try that sport you always wanted to try – talk a friend or family member into coming with you if you like.  See if you can find some old friends you’ve lost contact with – you might be surprised how many want to catch up.  Try that hobby you always wanted to take up.  Research your genealogy.
Purposeful activity.  This is what forms the building blocks.  This is where a healthy routine can be built.  This is where a healing routine can be built.  Research says it works.  My training says it works.  My observations of the people I have worked with as a mental health worker say that it works.  My experience of healing says it works.
 

It Works For Me 14/08/2011

In every culture there are certain norms.  Rules if you like.  What type of food people eat, the structure of families and social networks, the kinds of things that people do, our attitudes to authority and among other things our attitude to work.  In most western cultures the attitude is that you’re supposed to engage in it – but it’s also something to complain about.  The idea is to have a lot of other things you’d rather be doing.  Work, school all things regarded as ‘compulsory’ are often seen as restrictive.

I returned to work recently after a long absence from the workforce.  The initial period was due to a nasty relapse of depression.  Most of the months were while human resources were getting their act together pushing me through ‘independent’ doctors who were giving clearance for graded return to work plans all the while saying that the doctors had not said that I was not fully fit for duties.  It reeked of them trying to get rid of me.  Alas for HR, they failed.  I got back in.  What is more I got another job which I will start next week  and was offered others while they were stuffing around – with disclosure about my depression.  But enough on that.

Some of the Benefits of Productive Activity and Work

My return to the workforce has brought one thing to my attention in a stunning way.  I love going to work.  Sure there are some tasks that I could do without.  But on the whole, work is something that I need.  While I was off, I had to work hard to manufacture work for myself in the form of projects and I enjoyed them a lot.  But it feels good to be doing something productive.  To see people and say “hello” to them and pass the time of day with them.  And that’s before I’ve even gotten my first pay!  And to be busy.  I am enjoying being busy.

I am really fortunate this time too.  My latest medication regime is leaving me non-drowsy.  My attention is better in the morning than the afternoon – so I will have to gear my day around doing the close work that needs that kind of focus early, but otherwise things are looking good.  I am well.  The dog has gotten the message that he needs to stay at heel and not strain on the lead.  At the moment I am tired at the end of the day.  Very tired, but I am convinced that in the coming weeks this will pass. Some of this has been helped by the fact that I am not starting cold.

I am convinced that my determination to keep busy with projects that required concentration, busyness and maintenance of a routine while off work has helped enormously with this, because in this too the dog was given little space to roam free on my time and thoughts.  He essentially had to stay out of the way.

People, let me say that I am a convert.  I believe that people need work – not necessarily paid work – but productive activity of some description to keep them feeling like they are moving and breathing.  I believe that work brings freedom with it.  Sure there is a need to have support and watch your early warning signs.  Sure there are unpleasant tasks.  Sure there are jobs that you would prefer over others.    But work – work is grand!