This week I had the pleasure of giving a keynote address for one of the departments at PWC (Price Waterhouse Coopers). As part of this I ran through some of the things I have found helpful to help me monitor and manage my mental health.
I got some really positive feedback after the presentation and requests for the list of things that help me with my mental health. So I thought I’d share that list as a post here:
EARLY WARNING SIGNS AND INSIGHT:
In this context insight is the ability to identify early signs of mental ill health in yourself. This is much more challenging than it sounds, because signs of mental illness can masquerade as normal feelings and emotions.
For example – irritability and sadness are part of the normal spectrum of human emotions, but if they are overwhelming and persistent and interfere with normal functioning, they can also be symptoms of depression.
It can take time to identify their intensity or persistence as abnormal. The other challenge is that when we are well, we can often think our way out of sadness or irritability. But when they become symptoms that is impossible.
Someone affected by symptoms of a mental illness can no more think their way out of them than someone with a nasty case of gastro can think themselves out of their vomiting and diarrhoea.
But whereas vomiting and diarrhoea are obvious signs of illness (both to the person experiencing them and everyone around them) it takes insight to recognise when symptoms of mental illness emerge.
For me early warning signs can be an inability to sleep even with a lot of medication, intense irritability, and poor short-term memory and concentration.
Early warning signs are different for everyone. By learning what ours are we can be proactive about seeking help rather than waiting for symptoms to worsen.
For further reading on an example of insight into a depressive episode you can go to: Razor Blades In Mud: Laziness Or Depression?
SLEEP AND STRESS:
For me, sleep deprivation (especially paired with high stress levels) dramatically increases my risk of experiencing an episode of illness.
Sleep is also a barometer for mental health. Being unable to sleep normally can also be an early warning sign. For me, once mania or psychosis take hold I stop sleeping. During depressive episodes I experience early waking – going to sleep normally but waking in the very early hours of the morning and not getting back to sleep.
So, I look after my sleep when I am well and take notice if my sleep pattern changes.
Psychological tools can be highly effective at managing mental health either on their own or as an adjunct to medications. These can take the form of structured courses such as Cognitive Behavioural Therapy, or sessions with a psychologist. I see my psychologist every six to eight weeks even when I am well to keep my thought patterns healthy, and for impartial parenting and relationship advice.
That said I have found psychological tools are only effective at a certain level of wellness. Being in the middle of an acute episode of illness and trying to apply psychological tools is a bit like breaking your leg and going to the physio before the orthopaedic surgeon. You may need other treatments first to get you well enough to tackle psychological tools.
Psychiatric medication is shrouded in stigma and there is a lot of misinformation flying around about it. Like other medications they have potential benefits and potential risks. The benefits must be weighed against the risks in each patient to help decide whether to use them. I believe this should be done under the care of a psychiatrist, because they have the expert knowledge to deal with the highly variable responses to these medications.
Not everyone needs medication to manage mental ill health. But if someone does, they can no more think their way out of needing it than a diabetic can think their way out of needing insulin.
Medication is a big part of managing my mental illness.
However, it is not the only thing I rely on. I don’t take it and wait for it to just fix me. I still have to take care of my psychological and physical health.
Further reading about psychiatric medication on Thought Food:
Physical and mental health are closely linked. Unfortunately, once mental ill health takes hold, looking after physical health becomes more difficult, which can then exacerbate mental ill health.
For me, exercise on most days is as nonnegotiable for maintaining my mental health and managing my mental illness, as taking my medications.
I eat a mostly healthy diet, which includes coffee, chocolate, cake, and the odd glass of wine.
All recreational non-prescription drugs can potentially trigger and/or worsen pre-existing mental ill health. So, I don’t take them.
As for alcohol, I tread carefully. I don’t ever use it to self-medicate. I don’t drink at all during episodes of illness and during my recovery. When I am well and stable, I drink occasionally and in moderation and never around the time of taking medications.
For further reading on exercise and mental health on Thought Food you can go to: #NotFitspo
Wriggle room means leaving a bit of space in your life to recover from the blows out of left field.
Before I got sick, I lived my life booked to the hilt. Every bit of blank space in my diary was fair game. I functioned highly and was very productive. This system worked well for me. It was before I had children, my parents were well, I had a stable relationship. My only real stress came from work and I managed it.
For several years after I got sick I tried to follow my old pattern. But I learnt that if I left no space in my diary, then when an unexpected stressor hit it could be enough to make me sick.
If you are a high functioning perfectionist, leaving blank space in your diary feels counter-intuitive and is not easy at first. But it can give you some breathing space. And if nothing unexpected blows into that space you can find you have some pleasant time off to yourself.
Further reading about wriggle room on Thought Food: Wriggle Room
These are crucial to my wellbeing. I believe all the medication in the world won’t help you if your relationships are unhealthy.
Think of your mental and emotional energy reserves as a finite and precious resource. When you have a full supply of them you have the resilience to deal with almost anything.
Everyone’s baseline reserves may be different.
If you are experiencing mental ill health your reserves may be lower than normal. You may not control that, but you do control how you spend whatever levels of mental and emotional energy you have.
One of the fastest ways to drain those reserves is by maintaining unhealthy or toxic relationships. You are left with nothing to give yourself and it can precipitate episodes of mental ill health.
Cleaning up unhealthy relationships or cutting them loose takes work, usually with a psychologist, but it is worth it.
One of the questions I was asked after the presentation was about the impact of my illness on my relationship with my husband. If you are interested, this Thought Food article explores this subject further: The Support Crew
I was also asked about communicating with my children about my mental illness. These are two Thought Food articles which relate to this subject:
PRIVATE HEALTH INSURANCE:
Without my private health insurance, I believe I may not be here today, or I may not be recovered sufficiently to be doing this type of advocacy work. It has afforded me access to the highest quality hospital mental health care.
My impression from speaking with others who live with mental illness and have experienced the public mental health hospital system (in Australia) is that it doesn’t provide even an adequate standard of care.
If you have a personal or family history of mental illness, having private health insurance gives you more options when it comes to treatment. This is especially relevant should you need hospital care.
I struggle to practice self-compassion. I find it becomes especially difficult when I have been unwell for a long time and think I ‘should’ be better.
When I am well I hold myself to a high standard. There’s nothing wrong with that, but it can be a slippery slope between high standards and unrelenting, toxic perfectionism.
Although I am not good at self-compassion, I am much more aware of it and better at it than I was ten or even five years ago. My psychologist continues to help me work on it.
So if you struggle with a vicious inner voice talking you down or trying to talk you into what is unattainable or unmaintainable for you, stop for long enough to recognise it for what it is: Untrue and manipulative.
And then, be gentle with yourself.