Good Morning, Depression

This post may be triggering to some individuals.

9am – My eyes open when I hear my husband rummaging around our bedroom, getting ready for work. It’s harder than usual for him to find clean clothes, our laundry is piling up precariously high in the hamper. My dog jumps on the bed and comes to greet me. My husband says, “good morning sleepy head”, while I unclip my CPAP mask and turn off the machine. He kindly avoids alluding to my break down last night. I know from him getting dressed already that I have slept-in past my goal time of 7:30am. One of my first thoughts is how disappointed my psychiatrist will be when she finds out I haven’t been keeping a consistent sleep schedule. I remind myself that’s irrational, she will know how hard I am trying.

I slowly pull myself up in to a sitting position, noticing a crick in my neck, no doubt the result of mounting tension in my shoulders from high anxiety. “Great”, I think to myself, “more pain”. I was supposed to go see a massage therapist to help with the muscle tension in my upper body but I still need to figure out if that treatment would be covered by my husband’s health insurance. That’s a problem for another day.

I reach for my phone while my husband brushes his teeth. Last night a fellow comrade on Twitter was in crisis, I am hoping to see good news. I fell asleep shaken with the possibility that he wasn’t safe. There is strength in connection over social media, but the distance can sometimes make me feel so hopeless to help. I don’t see any news, I hold out hope that he will check in to Twitter soon to say he is safe.

My husband is back from the bathroom. He comes and gives me a kiss, says he is on his way out and he’ll see me later. I can’t hold back the tears. I wish I could cry elegantly like the ladies in romantic comedies. For the next ten minutes he comforts me, reminds me he will be home soon enough and that he can call me on his lunch break. Every touch from my husband gives me strength and courage. Every time he lets go I begin to sob all over again. I feel horrible, the last thing I want is for him to worry about me while he is at work. I have dealt with many trials from mental illness, but perhaps none so terrible as the dread of waking up and having to survive another day. I try to hide how much I am hurting, but I fail miserably at this practice. I calm myself down as best as I can and give him a final kiss. I don’t want him to be late. I suppress my sobs as he walks down the stairs, grabs his lunch and closes the garage door behind him.

After a few minutes of seeking strength from cuddles with my dog who so intuitively is clinging a little closer to me this morning, I get up to go to the washroom. Passing the vanity mirror I notice my reflection. Its distorted features bear a resemblance to Quasimodo. I had forgotten that I plucked my eyebrows out yesterday when the urge to self-harm was overwhelming me. My eyes are puffy from crying and dehydration, I must remember to drink some water today. My CPAP has left a distinct ring around my nose and mouth. My whole affect is droopy, the feeling of being weighed down that I have been dealing with for weeks can be read all over my face. “Invisible illness”, I say to my dog, “not so invisible today”.

The washroom is brighter than the bedroom. I wince as I enter it. I’d say that depression makes me feel like a non-violent vampire, but my affection for garlic denies me that claim. I reach for a pill bottle, but I don’t have one anymore having come off of my last antidepressant just a few days ago. There have been many attempts to find a daily medication that works for me, so far, no luck on that score. My bathroom routine takes longer than usual, mental illness at its worst wreaks havoc on my digestion. I skip brushing my teeth and hair, they are a mess but I am already drained from the few minutes I have spent out of bed. On the way out of the washroom I check that our medicine cabinet is locked, it is. My husband holds the only key, a security measure we put in place at the urging of my psychiatrist after one of my suicide attempts last year. It has often crossed my mind that I could break the cabinet open if I really wanted to, but the superficial barrier of the lock gives me enough pause to remember that is a bad idea.

I change in to a fresh pair of pyjamas. I have steadily accrued a large array of sleepwear; my agoraphobia has been crippling for the last two years so I seldom leave the house. Being comfortably dressed in pyjamas just makes more sense. As I slip on my stained pyjama bottoms I remind myself that putting on day clothing might help me feel more put together; working from the outside in and yada yada. But truly, that’s a struggle for another day. I remember the counsel my psychiatrist gave me last week, “Your job for the next two weeks is to wake up at the same time every morning, eat all three meals and stay out of your bedroom during the day. The rest is gravy.” This is sage advice, focussing on anything else right now might stop me from meeting those seemingly meagre goals.

Pyjamas on, I succumb to the will to crawl back in to bed. My head is pounding and my breath quickening. I figure I’ll relax for a while to ready myself to walk downstairs. On a better day the walk downstairs would be nothing to me, but today it is daunting. In bed I scroll through world news, frequently thinking how messed up our current political climate is. I consider texting my friends, but really who wants to hear from me? I spot that thought distortion, my friends routinely try to reach out to me. Nevertheless, that sentiment feels real today. My dog whines, he wants to play – I respond by snapping at him. I lower my head in shame, am I really irritable enough to take it out on my dog today? I gather him up in my arms and show him love. I fall into a slumber.

Waking back up, I resolve to make my way downstairs. I can’t bring myself to prepare breakfast. Instead, I find my usual place on the couch, allow my dog to jump up on my lap and begin watching the same TV show I have watched over ten times in the past couple of years. The familiar story helps distract me from the agony of my own thoughts. It’s now just past 11:30am, two and a half hours down, far too many more to go.


Take care,

Fiona

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Falling Off the Wagon Doesn’t Mean I Can’t Get Back on Again

* This post discusses self-harm and therefore may be triggering to some. *

Last night after over three months without self-injuring I succumbed to the impulse in a moment of panic. Today I am left in a sort of hangover of emotion over it. And much like with what I imagine accompanies most normal hangovers, I feel predominantly ashamed of myself. I have worked so hard to get to a place where self-injury isn’t a part of my daily life. I felt this was one area of my mental illness from which I had fully recovered. Yet here I am with fresh scratches on my arm and a head full of regret.

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Basically how my brain was talking to me last night. Photo from https://www.playbuzz.com/joppemaren10/10-moments-from-the-game-of-thrones-finale-that-made-your-jaw-drop

But you know folks, the road to recovery is so often full of twists and turns. It’s so easy to think that every moment of perceived weakness brings us right back to square one. But I am not in the same place I was when I was self-injuring multiple times a week. As discussed in a recent blog post, I’ve come out the other side of my two year long depression, I don’t hate myself or wish I were dead right now. I am able to be mostly compassionate and understanding towards myself where I had too often been judgemental and cruel. I am able to feel hope where I used to feel despair. So I refuse to let this slip up bring me right back to where I started.

I have used self harm for two main reasons in the past. The first is as a form of punishment when I feel guilty or ashamed of something. Kind of like Dobby from Harry Potter punishing himself whenever he thinks he is breaking the Malfoy’s wishes, but a lot more real and a lot less endearing. The second reason is when I am extremely anxious and having difficulty regulating my anxiety. These two reasons are not always mutually exclusive, the worst impulse to self-harm comes when I am both feeling guilty/ashamed and extremely anxious.

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Illustration of Dobby by Jim Kay from the Harry Potter and The Chamber of Secrets illustrated edition

Such was the case last night. Without rambling on too much, the next few days present quite a lot of huge challenges for me. On Sunday I am supposed to attend two major events for some of the most important people in my life. These are major milestones for those people and I would feel incredibly guilty if I weren’t able to attend these celebrations because I was too anxious; like I was letting them down or failing to show them just how much they matter to me. Then on Tuesday I will be beginning a group therapy program that I was unable to stick with several months back. This group therapy really triggered some things in me that I wasn’t prepared to deal with and I am not sure how I’ll react to it this time around. This is likely the most anxiety-charged few days I have had to confront since my wedding weekend in October.

Last night I found myself alone at home in the late hours of the evening, with painfully high anxiety. I couldn’t stop my thoughts from looping between how bad it would be if I attended the social gatherings and group therapy, and how bad it would be if I didn’t. If I did and I panicked, I might draw focus away from my two loves ones who deserve all the attention. If I didn’t than I wouldn’t be showing them how much I care and I would be missing out on a big moment in their lives. It felt like no matter what I do I’d be in the wrong on this one. I ended up taking a small dose of an anxiety med to help take the edge off but it didn’t kick in before I succumbed to the impulse to self-harm. Now I am in an even worse spot than I was before the self-harm because I can’t stand how embarrassed I feel when others notice my scratches, scabs and scars.

But back to the purpose of this post. All of that does not mean I am back to square one. I can’t let this bring me back to a place where self-injury is the norm. Falling down doesn’t mean you can’t get back up again and succumbing to the impulse to self-harm doesn’t mean I can’t master it again. I have to believe that. And I should, because I have conquered this before. I have shown to myself that I can regulate my emotions well enough to avoid this external show of my internal struggles. So I am going to rely more heavily on the coping tools I use to manage times of high anxiety and I am going to get through this without another scratch. And when I inevitably revert back to this maladaptive coping tool in the future I will remember that a moment’s mistake does not determine the future course of my actions. Because I cannot allow a disorder that I can’t remove to let me feel guilty. All I can do is manage it to the best of my ability and embrace the little victories as they come. I can do this… right?

Take care,

Fiona

Strategies for Coping with Anxiety [Coping Tools Part 1]

In my experience, living comfortably with mental health disorders is really all about trying to find ways to manage the symptoms. Even those who don’t have mental illness but struggle to maintain their mental health in times of stress or hardship can benefit from implementing some coping strategies. In this series of blog posts I will be discussing coping tools that have worked for me to help combat and distract from the impulse to self harm, cope with anxiety, get through panic attacks and withstand depression. I am not a mental health professional and if you are struggling with your mental health I encourage you to work with mental health professionals to help develop coping tools that are best suited to you. However, I have worked very hard in partnership with psychiatrists, psychologists and occupational therapists to develop practices that help me manage my symptoms, so maybe some of these ideas will be helpful to others too.

Today I want to talk about how I cope with anxiety. But first it is important to understand anxiety. If you already have a good grasp of anxiety then feel free to skip ahead to the coping strategies. Anxiety is a feeling that is normal and healthy part of life. Everyone experiences anxiety. When you are anxious as a result of being in a dangerous or threatening situation, anxiety plays a role in maintaining your health and safety. A commonly used example would be if a bear is chasing after you and you are anxious, that’s a good thing because it cues you to run! However sometimes our anxiety is disproportionately high for the situation. People can experience a higher sensitivity to anxiety during periods of stress, which can transform situations that would usually cause someone a tolerable amount of anxiety a higher more uncomfortable level of anxiety. There are also cases in which anxiety is disordered, in these cases a threat may be perceived even in cases where none exists.

When anxiety starts to get out of control, it can seriously impact your quality of life. You may even begin to avoid situations that could cause you anxiety. Below I will be describing some of the tools I have success using to handle my anxiety disorders. As my psychologist would say, it isn’t about eliminating the anxiety – that is often not possible, it is about “sitting in your discomfort” or in other words, learning to tolerate or cope with the anxiety.


Preventative Coping Strategies

If you are anything like me you might spend hours, days, weeks or even longer in anxious anticipation of something coming up. Maybe you have an exam or work project in a few days and you aren’t confident you’ll do well. Maybe you have been invited to a party and large groups of people freak you out. Maybe there is a big change coming up in your life like a move in your near future and you aren’t sure how you’ll handle the stress. Anxiety can’t always be foreseen, but if you know ahead of time that you are going to be in a situation that will make you anxious there are steps you can take to prepare yourself. The strategies listed in this section are also great ones to implement on a consistent basis to help keep anxiety in check in your everyday life.

Stick to a Sleep Routine

Have you noticed that your emotions are much more difficult to manage when you are tired? In my experience, nothing exacerbates anxiety quite like sleep deprivation. The difficult thing here is that for many of us our anxiety can get in the way of us sleeping soundly! If you are trying to manage your anxiety during a stressful time or when you are worried about an anxiety-provoking situation in the near future one of my best pieces of advice is to prioritize your sleep. Even if you aren’t able to fit in a full 8 hour sleep every night, try to set a schedule (i.e. I will go to bed every night at 11pm and wake up at 6am) and stick to it. When you go to sleep avoid distractions like electronics, light and especially TV in the bedroom. If your anxious thoughts get in the way of you falling asleep try to distract yourself before bed by reading, listening to an audiobook or calming music as you fall asleep or whatever other method works best for you! The key is to stick to a steady schedule and get as profound a sleep as you can.

Note: If you struggle with mental health issues and aren’t satisfied with your quality of sleep I highly encourage you to look in to seeing a sleep specialist. I recently learned that I have sleep apnea and I have been feeling a lot better since beginning treatment.

Practice Meditation, Guided Relaxation or Yoga

Working on relaxation techniques can help alleviate the muscle tension, fatigue and stress you can feel leading up to an anxiety-provoking event/situation. All sorts of activities can be calming, it all depends on what works best for you. Many people I know benefit from meditation and yoga. I have also heard a lot of people benefit from Progressive Muscle Relaxation. I personally enjoy using guided relaxation tapes, particularly at the beginning of a day that I believe will be high-anxiety. I even keep them on my cellphone so that I am never without them, that way when something unexpected comes up I can take a quick break to readjust and relax. Here are the tapes I use, in case you’re interested. 

Plan Ahead

Anxiety is often worsened by the feeling of loosing control. When I am anxious I have difficulty adapting to the unexpected. One of the best tools I have for this is simply planning ahead, being prepared so that when my anxiety is provoked I have anticipated it and can maintain control. I try to know as much as I can about what I am getting in to so that I can prepare for it. The more you can anticipate what will provoke your anxiety, the better prepared you will be to navigate it once it comes. 

Create an Exit Strategy

This one is pretty specific to the types of anxiety I face (agoraphobia and social phobia) but it is probably my #1 coping tool so I feel compelled to include it. One of my greatest sources of anxiety is finding myself in a situation that triggers me and I can’t leave. So whenever I leave the house or make plans with other people I always have an exit strategy. Obviously, there are a lot of situations that provoke anxiety in people that you can not just run away from. And running away from an anxiety-provoking situation can sometimes be detrimental in the long run when you could use other skills to make it through the situation instead. But if you are getting in to a situation that causes you a lot of anxiety and are worried about feeling trapped, an exit strategy can be a real saving grace. In my case this usually involves making sure that I can leave and I have a way to get home as soon as I decide I can’t tolerate the situation anymore. Going in to an anxiety provoking situation with the knowledge that you can leave when it feels necessary can make the anxiety all the more bearable.

Coping Strategies to Use While Experiencing High Anxiety

These are the coping tools I use most frequently when my anxiety is at its highest. These strategies may help you feel more in control and less overwhelmed when anxiety surfaces. When anxiety hits it is important to do whatever helps you withstand it, and remember that your high anxiety won’t last forever!

Play with Fidget Toys

Do you find that you shake your legs or tremble when you are anxious? If you do you may find using a fidget toy helps. I find that using a fidget toy is a great way to channel my excess anxious energy in to something without distracting me too much or causing muscle tension. I personally use Tangles and wood block puzzles that I keep on hand all the time. The repetitive movement is part of what seems to help me stay calm.

Engage Your Senses

Our senses of smell, touch, taste, hearing and sight can help soothe us. Think of things that you enjoy the smell, touch, taste, sound or sight of – could you envision yourself using any of those things as a calming tool? Perhaps you could eat a candy from your pocket, wander over to a piece of art and examine it while deep breathing, squeeze something soft, etc. You may find that you are in tune to some of your senses more than others, lean towards those ones. I think this works because when you engage your senses you are creating another feeling to compete with your anxiety which can help the anxiety feel less all-encompassing and inescapable.

Breathe Deeply

Anxiety can make your breathing erratic, even escalating into panic attacks when the anxiety is not resolved early. One of the best ways to tolerate anxiety is to maintain a steady breathing pace. Sometimes you may need to take a break to focus on your breathing in order to regain control. Your goal should be to inhale through your nose, allowing the air to fill up your abdomen, then exhale slowly through your mouth. There are several techniques out there that are taught to encourage deep breathing. Box breathing  is a common technique where you breathe in, hold your breath, breath out and pause for a slow count of 4 for each step.

Use Your Support Systems

If you are feeling anxious and have access to see or talk to someone who is supportive that can be a huge help. My husband is my main support system and helps me get through anxiety provoking situations. I can squeeze his hand or give him a hug for a quick release of tension. I can talk to him or have him encourage me to take breaks when I need to and recognize when I have reached my limit. Even if you don’t have a way of communicating with a loved one in the moment, there are still ways to use them to calm down. A couple of ways I do this is by keeping recordings of my phone from friends and family, encouraging me and telling me I can handle whatever is causing me anxiety. I also carry notes from my husband with me which are similarly supportive.Sometimes pets are great support systems too, my dog Midnight is a huge help to me when I am feeling anxious, petting him is almost meditative. Even just looking at photos of people you love on your phone can help. It is always okay to lean on your support systems when you need them.

Check Your Crisis Kit

A crisis kit is a little kit you assemble of things that can help distract you or comfort you in times of anxiety. Kits can be kept in things like a shoe box you keep at home, a pocket of your backpack or a bag of its own. Personally I have 2 crisis kits, one that I carry with me inside a pocket my purse at all times and a larger one that is in it’s own bag that I bring with me for higher anxiety situations. I plan to give a tour of my crisis kit in another blog post, but here are some of the items that I carry in them:

  • fidget toys
  • iPod and headphones
  • a note from my husband
  • tea bags (to engage my sense of smell)
  • hard candy (to engage my sense of taste)
  • small smooth rocks (to engage my sense of touch)
  • photos of my friends and dog
  • a colouring book and pencils
  • a journal

Accept Your Anxiety Without Judgement

Anxiety is frustrating, especially when you experience it frequently. It is natural to vilify it and get upset or feel guilty when you feel it coming on. One coping tool that I am working hard to embrace is allowing your anxiety to come without judgement. Instead of thinking, “I just want to have one car ride without freaking out!” I try to reframe my thought to, “Okay, I’m starting to feel anxiety which happens sometimes when I am in the car”. Judging your anxiety or beating yourself up about it only serves to worsen it. Whereas if you practice accepting your anxiety at face value it is much easier to move on to addressing it instead of fixating on how unhappy you are about it. Full disclosure: I am not good at this, but when I do put in the effort try to reframe my thoughts about anxiety I have found it helpful. This takes practice, but trying to allow anxiety to present itself without attaching additional negative emotions to the experience is worth the work.

Coping Strategies to Help Resolve Episodes of High Anxiety

After an episode of high anxiety I like to use coping tools to help me put the episode behind me. There can be a lot of unresolved feelings after you feel high anxiety. Allowing yourself the time to release the build up of anxiety and emotion you are feeling can help prevent you from carrying your anxiety forward. These strategies mostly focus on expressing yourself or showing yourself compassion after high anxiety. Resolving the anxious episode instead of swallowing it helps prevent me from avoiding the same situation the next time I am faced with it.

Write in a Journal

Writing out your experience with anxiety can be a great way to work through it. By writing in a journal you may be able to pinpoint some of what your most common anxiety triggers are and learn more about what most effectively helps you calm down. A journal is also a great place to vent out your frustrations so that it doesn’t spill out in to your interactions with people you care about. There is no right or wrong way to journal, just write in a way that feels good to you. You can write in poetry, as though you are speaking to a friend or an analysis of how you are feeling.

Express Yourself Artistically

If you are a creative person, artistic expression may help. I like to sing, paint or use adult colouring books to express myself. There is no limit to what you can do – draw, play an instrument, dance, sculpt, make crafts, etc. I find artistic expression particularly nice on occasions where I am not in the right head space to journal.

Practice Self-Care

Take a bath, read a book, play with your pet, go for a walk, give yourself a manicure, spend time with your best friend, play a video game, go to the gym, eat your favourite meal… Whatever makes you feel good! Take time to care for yourself and enjoy yourself. Avoid stewing in your anxiety or punishing yourself for it. Instead, indulge (within reason) in what you love. Self care helps me refuel so that I am better prepared to keep control of my anxiety going forward. A wise bard once wrote, “Self-love, my liege, is not so vile a sin as self-neglecting”. And if Shakespeare wrote it, that’s good enough for me!


 

I hope these suggestions of anxiety coping tools will be helpful to some of you. I want to reiterate that I am not a mental health practitioner. These coping tools are ideas I have been taught in therapy, groups, psychiatry appointments and hospitalizations that have worked for me. The best way to find coping strategies that work for you is to try out a bunch that sound good to you and see what you find most helpful. I promise, finding coping tools that help you manage your anxiety is worth it.

Take care,

Fiona