Yes, I am still here. Still living, breathing and blogging. Just fell victim to a couple of very shocking weeks (interspersed with some lovely moments, but very few and far between).
This week I’ve barely been able to tolerate daylight, let alone the computer screen – migraine like I have not had in a long time since my medication includes migraine voodoo concoctions … but … amidst my Barry Crocker of a week the week before and the ensuing weekend I became a bit disoriented and missed a couple of doses of my meds, hence the hole in the firewall (just to mix some more metaphors). Yesterday I went to the GP to get a medical certificate for work and stopped at the shopping centre on the way home. Talk about sensory overload! My world had not yet totally stopped spinning so I had this strange spacey kind of sensation as I was walking, the noises were louder and more jarring, lights and colours still bright, smells still sharp. I couldn’t get out of there fast enough!
Work has been crazy and exhausting trying to manage the politics and dynamics within the office. Don’t get me wrong – I like my job. If only work could just be about going and doing your job and coming home again, what a relief it would be! But there are systems and other people that one has to navigate to do one’s job. Equipment that one and space one has to somehow get adequate access to do it. Preferably in a way that lets you stay well without creating more stress than is necessary – which is where the battle lies at present for me. At present it seems that I am destined to bang my head against a brick wall and progress nowhere and to endure life in the office that gets claimed by miscellaneous team members to serve as their staff room – while my office buddy and I are trying to work in it!!!
But alas! These are not healthy things to dwell upon. The goal is to work out how to attack and push through. I had thought that we had had a strategy for the work one, but it is back to the drawing board on that one next week as it looks like this is rapidly fading into embers.
At present I am struggling not to dwell on the difficulties of the last few weeks. I grew frustrated that my usual seasonal dip in mood was dragging on longer than usual, but didn’t really look beyond it for other triggers until much too late. Sitting down with a friend a couple of weeks ago to go over what had been happening clarified things a lot more for me. One of the reasons that I am so focussed on work issues over the past couple of weeks has come about because through sitting down and working through my usual triggers and warning signs with my friend revealed that my workplace is simply loaded with triggers. There is little wonder that I have been struggling to emerge from my usual brief decline and regathering of mood.
It’s so easy to forget to go back to the basics when one gets busy. I can sort of see why Mary Ellen Copeland, the woman who designed the WRAP suggested that going over triggers and warning signs should be something that someone should do daily to prevent relapse. I’m not sure that I would ever go to daily, but I do know that I need to be going over my WRAP a lot more frequently than I do. The whole point of knowing one’s triggers and warning signs is so that you can be alert to them. It’s one thing to know them – but so easy to miss them unless you’re really watching.
So – What do you do with the shockers? Do you beat yourself up over them? There’s no point in that. To me, it seems you need to do is stand back and detach a little. Stand in the moment. Not the future. Not the past. Just the moment. Examine – and for me, it helps if I can find someone to help me stay in perspective … at least to get me going – and learn. This helps me to see cause and effect relationships; it helps me to learn and relearn trip hazards; it helps me see things specifically rather than looming ghouls and it leaves room to remember that there were a couple of good moments in the last fortnight too.
From there I can start with a plan. If the plan needs adjusting, then so-be-it, but perhaps – just, perhaps … next week can be a bit better …
If you have a mental illness do you tell your boss?
Are you obliged to tell your boss? Why or why not?
With discrimination rife in society and difficulty getting friends and family to understand what you are going through, what are your greatest fears in the workplace? Or the study environment? Or wherever it is you spend most of your productive time?
Does your illness affect your ability to do your job at times? In what ways?
Does your boss know? Do any of your colleagues? What led to them finding out?
Whether you are studying or working always consider ahead of time whether you are prepared to disclose your illness. If your current position is non-disclosure, consider carefully any occasions which might arise which might make it more necessary and under what circumstances you may disclose if at all.
Disclosure is always best done in a planned manner. You should have some idea what you are going to say, how you want to say it and how you are going to explain its relevance to your work. If you need some adjustments to your work conditions or some time off, it is best for you to come to your boss with some options that you have considered and reasons for your request. You need your boss to understand that you wish to be healthy and productive as possible and are trusting them so that they are able to best support you to reach a goal that is in both of your best interests. A large proportion of ‘Western’ countries, including Australia, provide legislation to support your right to this.
When you plan what to disclose think in terms of how you are affected by your mental illness more than your diagnosis. You may, in fact decide to disclose only the effects of your illness and not your diagnosis, stating that you have “a condition that affects …”. You may identify symptoms or you may simply describe what it does to you and how that affects your work eg my condition means that I have less energy than I used to have. This means that I have to be careful how I plan my time and that I have to take holidays at regular intervals throughout the year to maintain stable health. I need to be careful to use my meal breaks and leave on time so that I don’t become over-tired. Or my condition means that I need to take medication. When I change medications, sometimes I am more sleepy than usual and over-sleep or become very drowsy in the afternoons. Sometimes my speech even gets slurred and I sound a little intoxicated. So if I’m changing medications I need to take a week off, otherwise I find that I’m coming to work late all week and I sound as though I’m tipsy for half the afternoon and I don’t get much done and am at risk of making faulty decisions or overlooking things because my head is all foggy – especially in the first few days. After that I will be fine at work again, but might over-sleep a couple of times in the 2-3 weeks afterwards while my body gets used to the new meds. It doesn’t happen very often. I’ve only needed to do it 2 or 3 times, but each time I’ve been glad that I did.
You do not need to disclose specify personal or medical information if you tell them about anything at all.
You should also think about when to disclose. That is – when you are applying for a job, before a job interview, during the interview, after you have been offered the job and before starting, during the time you are employed after you have worked there for a while, if you become unwell and need to or never. There are pros and cons of disclosing at each point of the way. Sometimes your circumstances will have presented you with little choice to prevent awkwardness – you may have become unwell at work and have it become obvious that something was wrong or you may have symptoms that you are aware will soon become obvious if arrangements aren’t made to cater for your needs. Again, despite prejudice and stigma in some places you have legal rights to have your needs and confidentiality met and protected within your workplace in most western countries. Further, in Australia at least, if you become unwell because the employer failed to attend to your needs having been made aware of them, you are entitled to compensation under work cover. It is however, worth serious consideration whether or not you are going to disclose because unfortunately discrimination does still happen and there are people who do fail to respect privacy and you never know where they are until you find them.
Some helpful things to consider at each stage of the employment continuum.
Prior to interview
Why you might …
You are able to to discuss the organisations policies and support resources when exploring the prospective position
You are able to get an idea about your employer’s predisposition to your needs from the word go.
If you have restrictions on any key job criteria due to temporary limitations because of recent relapse/graded hours return to work plans.
Examples of Why you might not …
Risk of discrimination influencing whether or not you get an interview.
No work related needs arising from your mental illness.
You don’t believe that they need to know/believe it irrelevant to job.
At the job interview
Why you might …
You are able to address people after creating a positive impression of yourself and demonstrating your capability.
You can gauge their understanding of your meaning and clarify appropriate questions about your needs.
You are able to discuss with the employer positive traits that you bring to the team that you have learned through your journey of recovery.
You are able to discuss your needs and what your potential employer would be able to accommodate or explore during the interview process.
You can brief them as to whether your referees are aware of your condition and how it affects your work and offer consent to discuss previous workplace arrangements with other employers if they have gone well.
Why you might not …
Risk of discrimination in job selection.
You don’t feel that you have needs that require accommodating or can manage them without support from your employer.
You might worry about where information gathered by panel members will go and whether people are trustworthy to maintain your privacy.
Concern that even if you get this job, opportunities for advancement could be limited by poor understanding of your illness.
You might be well and consider it unnecessary at this point in time.
You might not want to distract the panel from thinking about your abilities by talking about areas of need.
When contacted with an offer of employment
Why you might …
You are able to discuss your needs without risk of missing out on the job due to discrimination.
You can arrange to enter the work place with a plan in place that accommodates your employment needs and commence as you mean to continue.
If required and with your consent, the employer can arrange appropriate mental health sensitivity workshops for managers or staff by organisations such as Beyond Blue or circulate general anti-stigma/population health information among routine organisation circulars, yet not make it obvious that it was for your benefit.
Allow development of appropriate support and mentoring systems.
Why you might not …
Fear of stigma, gossip and/or discrimination.
Currently well and don’t feel that you are affected at work.
Work does not need to know.
Protection of positive image and opportunity for advancement.
During the course of your employment
Why you might …
You decide that your employer is trustworthy.
You become unwell.
You encounter difficulties or are not performing to standard because of symptoms or medication side effects and need to offer reasonable explanation or require support, alternate work arrangements or time off for medication reviews etc.
You are being harassed or bullied.
Why you might not …
It might not be necessary.
Protection of positive image and opportunities for advancement.
It might result in harassment and discrimination.
You are able to manage your needs without workplace support.
Never disclosing
Why you might …
Protection from gossip and discrimination.
Protection of positive image and opportunity
Privacy
Stable health
Lack of necessity
Why you might not …
Difficult to prove entitlement to compensation in case of illness, relapse or deterioration due to failure of workplace to meet needs for psychological health if they were not disclosed.
Relapse or need for hospitalisation might put your job at risk.
Might discover a positive attitude to mental health issues within workplace.
Legal obligations under occupational health and safety act where specific work related tasks are affected resulting in serious risk issues.
What did I do about disclosure to my employer with my job?
For me it was simple. I told mine. I disclosed at interview. I felt that this was necessary because I had taken my previous job without learning to manage my mental health well and my references would have reflected that in the answers to some of the standard questions that interviewers ask referees no matter how careful the referees were. I chose to take control of this situation at the time of my interview because having reached interview I could present myself as a competent individual in person, demonstrate that I was healthy and create a positive impression before and whilst disclosing. I also needed to disclose because I wanted to work less hours than the position entailed and needed to offer a good explanation. I told them that I had depression, how it affected me in terms of energy levels, concentration, seasonal patterns, medication changes and how I managed these things to be able to work. I spoke of arrangements that I had previously made with my former employer that had been helpful and asked if they would be amenable to such strategies. I also used the opportunity to tell them things that I had learned and accomplished through the experience of working, the determination and dedication that it entailed and the commitment to my job that resulted so that I could achieve personal satisfaction through working. In my case this had a positive effect and outcome, although it doesn’t always. I don’t disclose before I have the chance at interview to sit down and talk with the employer so that I can get a gauge on how they are reading what I am telling them and to avoid preconceived assumptions about what I will be like that are difficult to shift. There are always risks associated with disclosure, but my reasoning is that if they are going to discriminate when I am well, I would rather not have to deal with them if I were to relapse.
When I am in the workplace I lay low for a while and watch what goes on around me. As long as they are not untrustworthy, I tell someone if they are closely and directly affected by my health so that they are not left in the dark if I have to take leave at short notice. That’s usually only one or two people. Often they are among the first to notice that I am off my game, so it can work in my favour because when someone who I work closely with starts asking if I’m okay and comments that I’m not myself before I notice anything, it gives me a cue to step back and check my early warning signs and triggers. Over the course of years there have been a couple of people who have learned how to pick my good and bad days at least as well as I do myself and also to support and accommodate me through the bad ones and to lean on me in return when I’m good. I’m pretty limited in what I disclose to start with, but with proof of worthiness comes more trust.
My current situation in my new workplace is new to me. I have always had employers who were fiercely protective of my privacy before. I have little in the way of evidence about my current manager, only the report of one other worker about two specific occasions of breached privacy. I have, however worked in a place where it has been possible to work with my information kept private and so I am prepared to stand for my rights in both privacy and in workplace accommodation now. If I expect the respect of others, there may be times that I need to stand up and remind them what it entails. This is however new to me and the workplace is one with strange dynamics.
I have included in the Fact Sheets menu this week a document called “Choosing Your Path. Disclosure: It’s a Personal Decision“. It’s about disclosure of ‘disability’ (or illness) in education and training after High School and employment and the processes of application, entry and engaging in the roles. The booklet discusses legal issues, reasons why one may or may not disclose at various stages of training or employment, responsibilities and some of the considerations to ponder in making your decision. Also have a look around the Beyond Blue website as they have a number of resources for work sites and managersas well as fact sheets about telling your employer about your illness and maintaining good mental health for tertiary education students. Lastly, I have listed a book called “Tackling Depression at Work” in the Books menu. I’ve not yet read this one, but it was written by reliable people and has been well reviewed so should be worth a read. I have listed the book at the publisher’s site, you may or may not be able to find it cheaper elsewhere if it interests you greatly.
I do. Mine haunts me. I can never seem to beat it.
There are the odd occasions when I do really well against it and I win. It feels great. I could walk on air.
Sometimes they last for a short stretch of time – a few days, a week – two if I’m lucky. I could fly.
And then
it all comes
crashing
down
in
a
great
big
thud.
OUCH!
And it’s not just me who is affected.
It’s not a small thing with small consequences.
What happens, you ask?
Okay I’ll ‘fess up.
I don’t wake up. Or if I do – I drop right off back to sleep before I can haul by backside out of bed.
Then I am late for anything that I have on for the day – visits, appointments, ….work.
And we’re talking regularly 30 – 40 mins late during the mid spring and autumn – and every now and then it’s a couple of hours. It affects other people when that happens – workers, patients … if I don’t get my work done it slows down the process of referrals going through, information getting to people in hospital and their treating teams for planning, people going home. It means groups can’t run or other people have to cover me. I nearly lost my last job over it. Even when well I’m often 10 – 20 mins behind my start time. I survive because I start before my boss and I always work back – but I can’t keep it up.
And it doesn’t seem to matter what time I ‘m supposed to start – I’ve adjusted starting times. It’s simply the process of getting out of bed and waking up in the morning.
Once I’m up, my sensory routines are helpful. I’ve started to experiment with some mindfulness exercises when I get time – which help a lot. But actually waking up and getting out of bed is jolly hard work.
The other thing that happens to me is that I lose time in the mornings. I do. Even when I’ve gotten up on time and have been running on time something happens – I space out in the shower or getting myself a drink and meds and time just vanishes.
I started a new experiment earlier this week that I think holds promise for the latter issue – I’ve started using a mindfulness breathing meditation exercise as soon as I get up that goes for about 10 mins to raise my level of alertness. If it keeps working at keeping me focused, I’ll be writing about that in a couple of weeks. But for it to work – I need to get up in time to have time to do it. It doesn’t need to be earlier – because I’ve worked out that I do everything else more efficiently when I do it. But I need to get up.
Sleepy-head
At present I use two alarm clocks set 5 mins apart – one to arouse my attention if I am in deep sleep so that by the time the second goes off I won’t sleep through it even if I sleep through the first. Part of me wonders whether it’s worth investing in a bed vibrating alarm clock – they make them for deaf people. It might be uncomfortable enough to help me move out of bed more easily. Has anybody ever used one?
I know the rules – go to bed early and get up and the same time every day. I’m awfully undisciplined at doing that.
Take your meds at the same time every day. I tend to get lazy and just take them on the way to bed – which admittedly is probably half of the problem. There are some very sleepy meds among my cocktail.
Every day is a new day with no mistakes in it – yet. Thank you, Anne Shirley – but other people remember and I need to work out the best way to deal with their memories and keep myself focused on the present so that I don’t drown in fright.
So here it is. My arch-enemy. The alarm clock. That moment in time that I’m supposed to get up. To get moving. To get started with the day.
Please – anybody with your own ghouls – what helps you haul yourself out of bed every morning?
I was reading from a collection of blogs not long ago about becoming mindful of gratitude and how positive this is for your health and well-being. Now I’m not a big one for karma or positive and negative energies or things like this – but with gratitude this is true. It has you thinking positively about things and when you reflect upon what it is you are thankful for there is a physiological response. Your body reacts to gratitude too. So helpful are the effects of your gratitude on your mind and your body upon you that experts beyond religious and philosophical teachers are now convinced that time spent meditating upon those things that you are grateful for and allowing yourself to reflect upon your gratitude is enormously worthwhile.
Now meditation does not have to involve any special costume, or ceremony. Simply a place where you can sit in peace for a few minutes in an alert posture and reflect in a focused way. If you find your thoughts straying – that’s okay too – all you do is bring them back to focus. If sitting doesn’t work for you try a slow walk or standing – but the goal is that you can be alert and not distracted from thought.
To begin with thinking of things they’re grateful for might – to some – feel a bit like Pollyanna’s ‘Glad game’. But it becomes easier if you are not used to it and will feel less of a reach with practice. To others it’s a bit hard to focus oneself on a manageable amount of things to meditate on instead of just churning out a list – either out of a genuine or obliged sense of gratitude. But the point is to reflect on them also. If you need something to help you limit your choices – pick a theme for a day and work with 5 things within that theme.
And so on that note:
5 Things that I am grateful for today:
1. My family. I have a really helpful and supportive family and even though they live all over the place we are in constant contact and any one of them would drop everything if they thought one needed the other. There is trust amongst us and love and fun and we like each other. That’s pretty awesome. My family has seen me through some pretty tough times and I’m extremely grateful for that. It’s not something they expect anything in return for. It’s just family to them. I have a lot to be grateful for in my family.
2. Faith. I have a faith that is new every morning and even though I don’t deserve it I have confidence that there will be peace for me in the end in heaven with God because of Jesus. Even in my darkest hours when I doubt myself I can believe this. For this I am grateful.
3. Sunshine. Today is gorgeous. The sky is beautiful and blue and the sun is bathing my yard all lovely and warm – getting ready for the summer to come. It’s been raining for a lot of the week so with the sun out my flowers are blooming and looking spectacular. When I go outside it will feel beautiful against my skin too. There is so much life sustained and nurtured by the sun. It always puts a life on my mood. I am thankful for a beautiful day.
4. Work. I have a job to go to. After the last 12 months I wasn’t sure that I would. I actually enjoy working. Sure there are parts of my job that I don’t like – but I like the job most of the time. I like to go and earn my own keep. I am grateful that I am able to work in a job that I enjoy and earn the money that I need. I like working with people. I am thankful for the opportunity to make a difference in people’s lives and also for the things that I learn from them.
5. You – my readers. You keep me thinking and looking into what I think about things. I am grateful to you for keeping me on my toes and exploring what is out there for people with depression around the globe. You remind me that I am lucky to live in a country where the government subsidises health care heavily and the standard of education of most of our health workers is good – as is the access to ongoing education. (Not saying that it’s not elsewhere – but grateful that it is here). I am grateful for the interested or curious minds that keep turning up to read what I have to say. You remind me that we can never get too comfortable in what we know and that we should always keep searching to understand more. You, by reading hold me to account to my opinions and knowledge. Because of you, I take my own advice and my health improves as well. This is something to be grateful for.
If there are around 7 billion people in the world, then I reckon that there are about 7 billion ways to explain depression. Seriously. Everyone is so different. Just when you think you’ve nailed a way to explain what it is and how it affects you, you come across someone for whom that explanation just doesn’t cut it. Now, I know that it’s not necessary to tell everyone what is going on. It is not everyone’s business and not everyone even wants to know. But sometimes it’s necessary – and necessary that they have an understanding of what depression actually is rather than just what they assume it to be. If someone is going to support you, live with you, take your sickness certificates seriously when they start piling up or you relapse in the work place – they need to understand more than just what they see at surface level.
So how do you get there?
How do you explain that you have this black dog that is constantly with you, even when under your command and at heel?
How do you help someone get past the idea that you could just put mind over matter if you wanted to?
How do you convince your boss that you’re not being lazy? Or taking sickies?
How do you convince your grandfather who is not very aware of mental health issues that you are not a hypochondriac?
Do you find yourself getting into arguments over these things? Being left feeling guilty and doubting yourself because of the things that people say? Feeling frustrated and defeated because they just don’t understand? Or just feeling out of your depth explaining the nature of depression, it’s causes, what perpetuates it and what helps to treat it and to support your recovery? You are not alone. Do you struggle to understand these things yourself?
The first step in becoming more confident explaining what is happening to you to someone else is to become more confident in your own understanding. Write down what you know. Organise your ideas under headings like
My Diagnosis (there are different types of depression):
Definition of diagnosis and Symptoms:
Body chemistry:
Thoughts (ie what it does to them, not necessarily yours although you may include a couple of less risky examples):
Behaviour (ie what people do because of depression):
Effects on function and everyday life:
Treatments that people use (ie medication and therapies):
Treatments I use: How well my treatments are working (and if you are thinking of trying any others some time):
Things recommended to help recovery:
Things that I do/am doing:
Things that are recommended for carers/supporters/workplaces who are supporting people who have depression:
Resources that I have found that might be handy to give people:
How did you go? Where are the gaps?
The next step is to dig around and fill in some of the gaps in your own mind. Make a list of the questions that you still have. You don’t necessarily need to have them all answered before you talk to someone about your depression – but they are there for you to follow up on for your own benefit. Sometimes you can also make a joint venture out of finding the missing information with the person you plan to talk to if they are someone who you trust. If anyone would like me to work through a series on these or to post any heading in particular I’d be happy to include something like this in future entries. Please put any suggestions or requests in the comments section for this post.
When you have thought through these things for yourself and written them down – if you come to a time when you need to pull your thoughts together for an explanation it is so much easier to do. The next thing to think about is this. What type of person or question are you dealing with?
People like your grandparents and some parents have been brought up in a generation where sickness is seen in form of a disease or medical issue – so with them, I would start by explaining to them the aspect of depression caused by biological factors and that it’s an episodic illness. Perhaps I would give them some information to read, or would talk to them and describe what happens – maybe draw a diagram of a synapse and show them how my neurotransmitters are out of balance. Then I would tell them the symptoms that causes and how they affect everything else. Then I would go back to my drawing and show them how my medication works and talk to them about why I need to keep on taking it. If they were interested and wanted to know more about my treatment, I might also explain that I go to a psychologist to learn techniques to overcome other symptoms too because they have become fairly stubborn and I get lost in them at times – but that I don’t expect that this will be like the medication, and it’s not like lying on a couch talking. It’s about learning specific skills and having time limited therapy that has been show in the research to be very effective in strengthening recovery and preventing relapse. I might then tell them about my goals and what I’ve been working on and how things are going. Lastly I would talk to them about what kinds of things experts say that family and friends do that help. If they wanted something to look at for more information, I would try for something from a doctor or official health site, in large print if I could find it.
Your boss might need a medical kind of approach too. With them I would also look for information for employers on one of the mental health support websites. BeyondBlue has a good one (http://beyondblue.org.au/index.aspx?link_id=7.980&tmp=FileDownload&fid=1176 ). It has another one about whether or not to disclose if you are considering the decision (http://beyondblue.org.au/index.aspx?link_id=7.980&http://www.beyondblue.org.au/index.aspx?link_id=6.1068&tmp=FileDownload&fid=356 ). I would stick to workplace issues only and be clear about how your efforts are going in relation to getting or staying on top of your work. Make sure that you are clear of your work place rights. If you are in Australia, BeyondBlue spell them out more specifically or direct you to a source. I’m not sure where international readers would need to go. Mr Google would, I’m sure.
For siblings and friends – it probably depends upon how they relate. Some will understand best if you describe it by its symptoms and numerous courses, some will need a scientific approach, others will need an explanation of the treatments that they see you taking and using as an entry point. Usually family and close friends want to know what they can do and feel frustrated when they feel helpless. It’s important to make sure to give them information about your symptoms, your treatment, what your doctor thinks is causing it and what they can do to support you. Sit down with them and talk about what helps if they are involved in your life. If they are not talkative people, gradually feed them things to read.
I’m not going to talk about young to school-aged children here because I want to talk to a friend who is a specialist in this area and do a special post specifically on this topic at another time. However, for adult children my advice is similar to that which I have written for siblings. Generally they want to feel that Mum or Dad is okay. Yes, it’s strange and they start hovering as though they were the parents and can get overbearing at times. Other times they may be so caught up in their own lives that they don’t even seem to notice. In both cases, it’s important that you are ready to educate. If you don’t have the energy for the conversation, young adults will respond to websites. Sending them to http://www.beyondblue.org.au , http://www.blackdoginstitute.org.au and http://www.scottishrecoverynetwork.net will get them well oriented to Depression, treatments and some people’s experiences stories if they look around. There are also great resources there for family and friends. Then they can come back and talk to you about what they have learned.
Then of course there are your parents. All the strategies in the world will not stop their concern at times. This is part of their world. For most people, when things are hard – all a parent wants to be able to do is make it better, easier somehow. It’s the nature of the role and love that they have had no matter how old we get. I am aware that there are people who are not lucky enough to have families who have cared for them like this – but on the whole, a parent’s response to any perception of threat to your wellbeing is a desire to protect you (remember, that one that’s been driving you nuts since you were at least as young as 14). When talking to your parents about your depression remember this. Once a parent – who has considered themselves a carer or a protector throughout your life when you have been unwell or threatened – accepts that you have depression and understands the nature of the illness, they will find it difficult to respond to as well. It is good to have information designed for families and carers for them if they find watching you struggle hard. Make sure that you spend time talking with them about what helps and what doesn’t. Calmly. Write it down first if you need to. I share things to read with my family. They don’t say much, but their education shows in the things that come up when we are talking about my health or my plans for the future.
My observation from working with people who find their parents “too interfering” is that often in by not telling them anything about what they are doing for their depression – is that a lot of the parent’s interference is related to ignorance; and that more, rather than less information about what is going on, better education for the parent and some help to reassure the parent that their son or daughter is making healthy choices goes a long way toward defusing the situation. I know that this is not true in every case, but frequently it is. And while some of the parents need to learn better adult boundaries, others are just desperate for the wellbeing of their son or daughter. It may not be possible to put all of your parent’s concerns to rest. This is not your job. Nor is it your job to protect them from ‘finding out’ – because ten to one odds say that they have already noticed that you haven’t been yourself for a while and are already worrying in secret if bothering to hide it. Explaining the true shape of the issue that you are dealing with and telling them how they can help rather than leaving them to shadow box with the ghosts they imagine is all that you can do.
Sometimes, unfortunately, like we might have been to start with – the people we care about or people we need to know may also remain in denial of depression in someone they know. This is very hard. Sometimes a family member might respond if they come to the doctor with you. Other times it may be a case of letting your treatment and the efforts that you are putting in prove themselves over time. It is hard to be motivated to do this with someone saying that you are being lazy or playing sick. It doesn’t help the thoughts. It can increase anxiety. It is humiliating even to one’s self. If the person won’t respond to your attempts to talk to them or to give them information, unfortunately it is difficult to make their choices for them. However, the best way to deal with them is to prove them wrong. The best way to prove them wrong is to prove that the treatment that you are undertaking and the effort that you are putting in is having an impact. Even if it’s a partial impact that goes in fits and starts – change can be a catalyst for more change. Perhaps seeing a change in you as you progress will convince them that there was something to that information that you tried to give them a few months ago…
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.
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.
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.
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.
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!
I live with a black dog. It follows me everywhere. My philosophy now is that I need to plan for its needs when I plan for my own. I also need time out and restful places to enjoy the warmth of the sunshine on my shoulders.
livingwithablackdog 