livingwithablackdog

sit. stay. good boy.

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.

 

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!

 

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.

 

 
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