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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

 

 

 

Just One Moment … 14/10/2011

The alarm clock rings.

Perhaps.

I drool.  I roll.

The dog opens an eyelid.

I haven’t moved yet.

The dog opens another.

I am snoring lightly.

His head lifts.

Tilts.

He listens.

I am breathing.

Not that he cares.

The dog rises on his haunches – quietly – all the while waiting for me to stir.

The song changes on the clock radio.

The dog waits.

But I don’t move …

… and slowly, slowly he rises to his legs and creeps out of the room.

The black dog roams free in the house.

And I sleep on.

Eventually, much later I wake.

I look at the clock.

%##@@

And then I see the empty patch on the floor …

and I know that something worse seems to be afoot.  I haven’t just slept through an alarm this morning.

The dog is at large in the house.

I fall back on the bed and close my eyes in dread.

What awaits me?

How awful will this become?

Can I face it again?

I pull the covers up over my head and try to snuggle back down to sleep.

It’s not really happening.

But I can’t do that anymore.

I’m not the same person that I was last time I found myself like this.

Bloody Dog!

Now I have to go and clean up this mess.

The mess.  Can I face the mess?

Sooner or later I have to.  I’m really just putting it off lying here in dread and imagining.

He’s only been loose a little while.  How bad can it be?

Bad.  It’s been bad quickly before.

Come on.  This is getting us nowhere – time to move.

So eventually.  Eventually.  Eventually – I do.

I was right.

He’s been everywhere.

But unlike before, I can catch him and rein him in reasonably quickly.

Sure, this leaves me tired.  But not defeated.

There are muddy prints where the dog has been – but all they are are the traces of his lies upon my consciousness.  I can clean those.

Tonight the dog is back on his leash.

Tonight is evidence of what gains I have made with the help of my psychologist in learning to be conscious of my thoughts, emotions, my actions and how my body is responding to situations and to be deliberate in how I respond to this.  Tonight I remember how these things used to crush me.  How encouragement was drowned out by self-derision.

Today my dog got off the lead.  Today I caught him again.

Yes, it made a mess of my morning.

Yes, it upset me.

But today, I could hear encouragement when it was offered by someone supportive.

Today Mindfulness skills allowed me to feel and experience the emotions of the moment and yet use the CBT strategies that I have learned to right my perspective and reorient my day so that I could finish it feeling like I had accomplished something useful.

Today, the dog has finished his day at heel.

 

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 Jealous Dog 22/07/2011

If there’s one thing that discourages a jealous dog, it’s competition.

Sounds simple, doesn’t it?

Of course like everything that sounds simple there’s a journey involved in getting to the bit that’s simple.  And at times the times the ‘simple’ bit is anything but easy.

If you were to tell me in the depths of my depression that competition was all that was needed to discourage the dog – that having other, more enjoyable things around me would make life easier to manage I would probably knock you flat.  And I hit ‘like a girl’.  When I am unwell they probably do knock the edges off things, but enjoy … ? Perhaps.  I certainly need help to initiate the diversion and the routine.  Ah … the old ‘r’ word.  Yes, I must admit – it does help.  I just hate it.  I never feel like it and it’s damn hard to do.  Especially when I still lack the sense of enjoyment of anything.

But further on – about eight months ago I gritted my teeth and reestablished contact with a long-lost world.  The friend.  The ones I lost contact with during a couple of years of withdrawing from – well – life in general.  Initially it was very tentative.  After all – who would really want to be friends with me, right?  But no, contrary to my very localised opinion friends welcomed me back with enthusiasm … on-line, phone calls, coffees, visits and finally a trip to see someone who lived a long way away for a few days (I was very nervous about this one) which was lots of fun.  I now have friends who I talk to again regularly and see when our schedules allow it, an old school friend I catch up with regularly, friends kids who are excited when I come to visit and people who miss me if I’m not around.  I never thought I’d see the day.  I’m still not sure I believe it.  By rights I should have black and blue spots up and down my arms from where I have been pinching myself but if it’s not true, I’m not planning to end the dream any time soon.

Today is my first day at home after a couple of weeks on holidays – staying with the same friends that I visited earlier in the year.  I was originally going for a few days, but the family with whom I was staying voted unanimously that I should stay longer – so I did.  I visited with other friends and their families on the way home, including one family not far from home where I stopped in filthy weather with an hour’s notice to drop onto their couch for a night.

Amidst all of this my dog stayed at heel without challenge.  This is amidst ongoing bungles with a return to work plan that has been drawn out for months.

My dog is shy around people who value me.

I need to remember this next time he pulls me in close to home.

A black dog needs a little competition from people who care.  He just wants me to believe that there aren’t any.  I did once and it turned out to be a lie.  I must remember this for another day.

My dog lies.

 

The Stranger 04/07/2011

I sat down to do my WRAP a few months ago.  My Wellness Recovery Action Plan.

The idea is that you describe what you’re like when you’re well, what helps you stay that way, what your triggers are and what you plan to do when you encounter triggers to prevent spin-off effects; then what your early warning signs with an action plan for what to do if you notice them emerging; also what happens when you’re feeling much worse and again what helps in those instances.  You also make a crisis plan, identify supporters and how you agree that they will support you/what you would like them to do for you, identify people who you don’t want involved in your care/treatment and people who need to be notified, your current meds etc.  There are a whole bunch of different ways of a similar process.  Mary Ellen Copeland’s Wellness Recovery Action Plan is the one that I have been using – and hence describing (see link to website).  The point is then to read it regularly – she recommends daily and to stay on top of your management plan and to know yourself, to recognise when you are not yourself; to be watchful and vigilant for triggers, warning signs and symptoms and to act immediately, instinctively.  Also she recommends to have a couple of others who check in with you regularly to help out and give you their perspective or who will tell you if they notice that things don’t seem right.

I think that almost the hardest part of the process to complete was the first question.

“What am I like when I’m well?”

It had been a long time since I had been well for longer than a few months at a time.  What’s more, I have changed.  I am not the same as I once was.  This battle – this relationship with my dog has changed me.  What am I like?

I was in my mid twenties when I had surgery for a massive aneurysm.  Somewhere over the period of the next five years came the prodromal and early symptoms of Depression without being diagnosed until I was almost 30.  I have been wrestling to learn self-management skills until reasonably recently.  It has been a long time since I was truly healthy, although between brief periods of mood change or minor undiagnosed episodes in my twenties until my eventual breakdown with depression I’m sure I was fine.

My point?  What am I like when I’m well?  I don’t know anymore.  What’s more, it always feels like such a silly question to ask other people.  I mean – asking people to help me to identify what I’m are like when I’m not well … that makes sense because I know that my insight is not at its sharpest.  But well?  Shouldn’t I already know that?

Not that I was ever good at describing myself.  Always self-critical, I was never particularly sure why people wanted to be friends with me after leaving school when I had hadn’t had many friends at school.  But that’s school for you – start school somewhere awkwardly and the perception sticks with you til you leave.  Even as an adult I struggle to have a clear picture of what I am like.

What am I like when I am unwell?  What helps when I am unwell?  These questions I can answer reasonably these days.  I have even thought to discuss some of this with others or take notice of comments that they make.

But to know myself well.  To know the self that has been changed by this dog of an illness, by periods of chronic pain, by a swollen blood vessel in my brain waiting as a time bomb for its final burst – but found before it could; the self that has been altered by periods of self-imposed hermit style living apart from the workplace.  This is a person that I must relearn.  This is a person whom I have lost and who has changed while she has been away.  She is a stranger.

I need help to know this person.  Friends.  Family.  Memories.  Time to explore the things that interest me again, to develop new ones.  To reflect.  To do.  To explore.  To discover. To learn.  To grow.  To live.

 

The Phantom 02/07/2011

I have a secret identity.  Not just a pseudonym.

She appears when the black dog prowls.  But she’s not a superhero.

Her superpower? She melts into the weave of the sheets and the very mattress on my bed like 3 day old macaroni cheese sauce on the lounge of a bachelor pad in summertime.  She can barely roll over and will do anything not to.  Almost anything.  She won’t wet the bed.  She will tell you the most atrocious lies in the universe.  Anything to make you go away and leave her alone there.  She barely eats or drinks – far too much effort.  She stinks – goes for days at a time without a shower or cleaning her teeth.  The thing she does do is sleep.  She excels at that … except when she needs to.

And she can never tell you how she got to that state.

I am pleased to say that she has only taken a firm hold on my space a couple of times, but cleaning up after she has even attempted to gain entrance is a nightmare.   It’s hard work chasing her out when she’s just passing through and catches me out.  Next thing I know, there she is sitting there.  She’s not looking like moving anywhere.  She looks like she knows she’s not welcome, but can’t bring herself to move.  A lazy visitor.  In the way.  Impeding the things that need to be done.  And looking like she’s stay the year out given the opportunity.  She has no sense of time.  Little sense of purpose.  And little sense of the ‘other’.

And then I look over my shoulder and see my dog pacing.  He’s never still when she’s around.  They feed off each other.  Stalker and sidekick.

I am learning that the secret identity has more pitfalls than safeguards.

Superman.  Batman (without Robin).  Spiderman had pretty lonely existences – and they were the good guys.   Secrecy is isolating.

Maybe just one or two people need to know about my secret identity.  Need to know now while she’s not around – so that they know to come looking before too long if I disappear; so that they know what to do with my secret identity before she takes over again completely.  So that they know when to say “Bulldust!” and when to be gentle.  So that they know that I am also vulnerable to her bullying ways for short bursts while I am physically sick.  Not everyone – just a couple of people.  Perhaps then one or two will know to come not call.  To peek in the fridge.  To offer a lift rather than remind me.  To ring just that little while after I say I’m planning to be up in the morning for a chat – til I sound like I’m awake and alert and up for the day (and to try again in ten minutes if I don’t answer in case I was in the shower or just missed the phone).

It’s hard to disappear when there are a carefully selected few making constant contact and stripping away the secret identity.

Soothing the dog.

Because everyone needs someone who will come looking.  The biggest question is – is there anyone I trust enough for that task?

Do I want to share the ugly signs that show that my black dog is starting to pace?  That the secret identity is moving into play?  How do I decide who to share with?  How much can I ask of people who put up with so much from me anyway?

But if it means avoiding the black dog at his worst …

If it means I can keep a job ….

If it means keeping a friend …

If it means not exhausting my family through another painful and exhausting regathering process …

If it means keeping some perspective on life …

Perhaps I am asking less of people than I am by struggling on alone.  If only I can bear to share the secrets with those close to me …

… in exchange for those that they have already discovered that I have been too blind to see.

 

Who Walks Whom? 29/06/2011

I was talking with a friend yesterday who commented on the extraordinary difficulty of the last few years.  She asked about how I’d coped with my depression at different times, what kind of treatments I’d had, the other health problems that had intruded – because there have been significant episodes of those also – just to poke bruises into bruises and how I felt that all of this had affected me.  None of these things are new topics.  They are things that I have had a lot of time to reflect on over the past eight months in particular and to use to build into my Wellness Recovery Action Plan.  But here’s a question it raises for different periods of my life over the last eight – no, realistically the last thirteen years – if I count back to my surgery:

Who walks whom? Was I walking my black dog? … or was he walking me?

For large proportions of that time, my black dog walked me.  How I responded to that varied.  Sometimes I trundled aimlessly along behind him without the energy or fight to do anything else.  Sometimes I would simply sit down and refuse to be moved anywhere and let him pull and tug away at me or haul me along as I sat.  Other times we would do battle – although the amount of energy I had to put into the fight would at times be outweighed by the dog’s.

For example, I injured my back and had chronic pain for months.  Months I fought the pain and the black dog became just another thing to fight, but my fight was strong.  However by the time the back was better, my fight was gone.  My energy was gone.  Before I knew it, my black dog was taking the lead as we walked and I had simply fallen in step with him without the wherewithal to reclaim authority.

Exhaustion does that.

Walking does that.  Especially uphill battles.

How does one keep on walking day by day without getting exhausted?  By walking.  By familiarity.  By over-familiarity with the scenery.  Boredom.  Work.  Idiots.  Medications.  Side effects.  Doctors.  The same stuff as everybody else.  The bloody dog.

I don’t know how to answer that.  All I know is that I can’t afford to let the dog lead when I am exhausted.  I need to stay the one who is the walker and the dog needs to stay at heel.

I think the answer is more related to ‘how do I know how far I can walk?’

I think the answer is related to ‘how do I know when my dog is getting ready to challenge my authority?’

Perhaps the answer is more about pace than distance.  More about awareness than knowledge.

You take a puppy to puppy school and you learn nothing – your puppy doesn’t get trained.  I think that this is also true of depression.  You don’t train black dogs, you teach their custodians how to keep them in check.  Some are easier to keep in check than others.  Mine’s resistant – a mongrel of a thing – but others have worse.  At least I can work with mine.

My black dog needs a leash.  It should not have a halter.  It is not a guide dog.

It must walk at heel.

I must keep my black dog at heel.  I must be alert to his movements.  Too often I have let him have his head and too often I have paid the price.

Heel dog.  Heel!  Good boy.

 

 
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