Part 2: The Plan
Approximately 50% of the population in Australia will experience the symptoms of a mental illness sometime in their lives. That means experiencing significant difficulties over an extended period of time with the basics of our day such as thinking (organising, problem solving, memory), feelings (distress, shame, fear and terror), and behaviour (physical health, relationships, work, study, verbal communication). A Plan to deal with these situations is critical – and not complicated.
I always try to have some kind of a plan – it gives me a sense of control, to help me gauge where I am in the grand scheme of getting well. The Plan reminds me have what is best to do, lets my loved ones know where I am at, and what’s going on. Ultimately, I also try to focus on things I can Control. I was reading a book called ‘Complex PTSD – from Surviving to Thriving’, and felt I was not in the surviving category – I wasn’t actually able to live my life. That’s when I thought, at the time, I was Drowning. At that time I was scrambling for Survival. I drew a line, and listed these categories, as if on a continuum (below). For me, the plan is about moving from one end of the continuum to the other – from unwell to well – and maintaining that. It’s just about levels of degree of Intensity of the pain, and the Density of the nasty daily experiences – trying to reduce the intensity, and the density.
The things I can control include:
1. The direction of my focus – What am I reading, writing, thinking about?
2. What I do physically – Do I exercise? Do I get out of bed?
3. Making the most immediate choices – concerning relaxation, medication, psych etc.
That’s it. These are the things I can control. Keeping it really simple. For me decisions I make basically fall in the categories of either ‘Feeling Better’, or ‘Getting Better’ (thanks to Albert Ellis). Feeling better is about just that, momentary change in mood and emotion, that is all important when you’re unwell with any health condition. It also helps you to be present, sociable (family and friends), and to navigate your mental environment. Feeling Better is a huge part of your life, and should be given huge respect. Getting Better overlaps a lot with feeling better, but is more long term. Getting Better for me is about adaptation. It’s about making changes. Something that happened years ago has resulted in disturbing memories, thought patterns, emotional habits etc. Basically ask – Is this task I am doing going to help me feel better, or get better? There is no argument that drinking alcohol gives you a momentary reprieve (Feeling Better) from the nightmare and pain, which helps me short term, but it is not Getting Better. Getting better is about understanding current experiences, how they surface, hey they effect my life, and how I can make changes to improve my mental, emotional, social, and behavioural situation. I do this in a number of ways through out the day, and over the weeks. There is no prescription, and I had to work this out on the go. Below is what I did, as best I could at the time (I will discuss what I learned on part 3). It is listed out into categories for simplicity, and in no particular order. I had thought about making the list according to either feeling better or getting better, but some do both, and others are quite clear (e.g., wine = feeling better; psychologist = getting better).
Safety: The concept of safety was a new concept for me. I made a list. It was short, and ended up revolving around home. I realised my safe spaces were sofa, bath, and bed. So I used those spaces as the foundation to help me navigate the challenges.
Work/Study: Work stopped apart from the almost weekly SUP sessions for the Mental Health SUP program. No future planning/booking/training. For study, I read and wrote on a weekly basis, when I could. For that time, a trickle was enough to keep moving forward and connected to what I was studying.
Diet: This was a real struggle mostly because I just didn’t care that much, and I mostly went for what helped me feel better (chips and wine from afternoon until night). But, I did get good food in, meats and vegetables, and at least a litre of water a day. I’ll write in Part 3 about the change in symptoms that signalled for me to drop the wine consumption.
Physical Activity: As I have mentioned before, I tried to get out of the house to exercise when I felt I could. I had made the decision, it had to be something I enjoyed. So, this included Stand Up Paddling, Outrigger canoe paddling, Mountain Biking, Surfing, Bushwalking, and Yoga.
Relaxation: I took baths with lots of magnesium sulphate almost daily for relaxation. For me, there is something about water I enjoy. So if it is not ocean, then it’s baths. I read, watch YouTube for information, inspiration, and laughs. I also started doing body scan mediations in bed. These took the format of Yoga Nidra practices which really focuses you mind to relaxing each and every part of my body. I did them 3 times a week, 45 minutes each time, and during the day so I wouldn’t fall asleep. Lastly, we have a fire pit in the backyard, and I used it almost every night. It’s relaxing, almost meditative as we all know, and for better or worse also goes really well with books and wine ;-).
Communication and Social Support: Throughout the nightmare, including early stages and during recovery, I always talked with my wife. I tried to keep it simple for us both, tried to involve her, explain where I was at what the psych said etc. My social life was her and our son, again, keeping it simple. Social Support is critical, and should not be confused with Getting Help. Getting Help (GP, talk therapy etc) is more focused toward Getting Better, where as social support is generally about Feeling Better. But, it can be so much more than that. Social support helps you feel you’re worthy on the planet, and in their lives. Good relationships support good decision making in your life towards being and feeling well. I think of it like this: if I were to have cancer, and go for a beer with a mate, I still have cancer. But I have benefited from that relationship contact which impacts my mood, emotion, decision making, and future actions. It doesn’t matter if you have 1 person, or 25 people around you, make sure they are the right people. For me, the right people are those that genuinely care about people, period, and this includes you.
Reading: Reading for me was about learning. I had discovered a book titled ‘Complex PTSD – from Surviving to Thriving’. This book was really helpful. I read for very short periods as it was challenging. When I felt triggered, I would stop and do something unrelated and light-hearted to recover. Later, I would get back to the book. I also read articles about trauma, nightmares and anything else I could get to understand.
Watching: YouTube can be a real friend. For learning, it has mountains of information regarding mental and physical illnesses, helpful strategies, interviews, and uploads by people going through similar challenges. There is also heaps of (interesting) crap on there for deep distraction (I love sport). When I was struggling, I would watch hours of stand up comedy. I know comedy really saves me at times.
Journaling: From early on, I made a list in Evernote (online journaling platform) about my Plan. I had separate sections on diet, exercise, sleep etc., and made a choice to daily add thoughts to the sections I thought were important that day, or if I just had something today. Did I write everyday? No, but I wrote regularly enough that it helped get things clear in my head. I can look back now on all notes and continue to evolve the ideas about my mental health. The psych had at some stage asked me to draw an animal I perceived as ‘safe’. I draw our first pet dog from when I was a kid, I thought she would always protect me. This activity gave me an idea to do some sketching in my paper journal. I would find a sketch on google images that would represent how I was feeling, and sketch it. It helped as it was a wordless expression, it’s a mindful activity, and also showed to my wife emotions that were so difficult to explain. I later started doing sketches that I found enjoyable.
Demons: Demons (the Shadow according to Jung) was one of the sections in my online journal. We all have the foreground negative thoughts, emotions, beliefs, internal conversations, but it was what was the ‘background chatter’ that was the real enemy of well-being. The whisper – “you’re worthless, useless, dirt”. This is on top of the negative thoughts and emotions about distant traumatic memories – it’s the voice about myself. This was not new, and was something I had battled all my life. However, it had caught up with me. I didn’t want the echoes of the past to be causing any more pain. Demons are more than memories, they are thoughts and emotions, my ideas and beliefs about myself and others, and what my life is about. I needed to know them, to recognise them each time they popped up during the day – the opposite of suppression. At the time of writing this, these demons have much less of an impact. I can see them now, from how they affected me in the past until now, but now they have less teeth.
Talk Therapy: I feel this is crucial whether you see a psych, social worker, counsellor or someone else. Suppression is a significant issue, and having someone to dig through the mess with is vital. I needed to get the worst of it all into the light so I could promote far fewer unconscious effects such as dreams, emotions, and flashbacks. My advice: get a therapist that is on point, has a plan for your particular issue, doesn’t ask “what would you like to talk about this week?” They have the plan – do a check in at the start of the session – and then get on with the plan each session. I had one thing to talk about with 10 sessions, not 3 years, so let’s get on with it. During the week or so between psych sessions I would make notes in a paper journal about thoughts and ideas, and bring that with me, then make notes about the psych session. I have seen counsellors and social workers in the past. This period I started with my 4th different psych, and it was the right choice. At some stage I decided to see a Psychiatrist that specialised in PTSD to make sure I was on the right medication, and the right overall formulation which included medication, psychologist, work and study, and exercise.
Medication: Over the last few years, I have been on a low dose of a common antidepressant. When things were starting to get rough, I increased my dosage up to double to help with the nastiest of the symptoms. I felt this really helped to put it up. Always check with your doctor for advice before changing dosages.
It’s important for me to know that I have been surviving at times, and drowning at other times – and all that I can control is focused on the scramble for survival. I give myself a good shot of being well when I take care of the basics of health and wellbeing.
End of Part 2.
- Part 3 is about The Recovery: There is a time where the bad starts to decrease, and the good starts to increase again. There can be a light at the end of the tunnel.
- Part 1 is an introduction to a Mental Health Nightmare: It developed over a couple of months, not a crisis, but a nightmare where I felt I had zero control.