Swimming upstream

Apologies for the post being so late this week but I have been struggling to find the motivation to write and also been unsure of what to write about. Since I know so many of you often feel the same I decided to just write about how I am feeling right now and the apathy that has entered my world. This year has been a particularly difficult year for me, from the onslaught of my episode in March nothing has quite come right yet and I am starting to forget what being me feels like. I seem to have moments of thinking everything is getting better and things are returning to normal only to lapse into melancholy or lose my motivation for anything a few days later.

I do not feel depressed, I do not feel manic, I do not feel much at all. The emotions are still there but muted, like a cellphone which is on vibrate instead of ringing. I get up every day, I go to work, I honour the commitments I have made to go to meetings or social engagements but I feel no spark. Instead, I feel exhausted, exhausted with the energy it takes to keep moving, to keep putting one foot in front of the other. I am ‘okay’, using the term to mean what a counsellor once told me. When I first went into the clinic, I and many others there, used the word ‘OK all the time. We had no idea how we really felt or were so used to lying that it was easier to just say we were okay or fine despite how we were really feeling. In one of the lectures a counsellor banned the word and explained that being okay is not enough, that in war when soldiers are dying on the battlefield, medics would run around trying to assist as many as they could. In order to make their jobs easier soldiers would say they were ‘OK’ if they were hurt but not in need of immediate help. (I don’t know if the story is true or not but I like the explanation and it gets the message across) I am okay, I am hurting but I am not dying yet. Do you feel like this sometimes? Do you know others who feel like this?

For months I have been struggling with my sleep, since leaving the clinic in April actually. Some nights I get a mere hour or two of sleep, if I am lucky I manage to get up to four hours but not often. I feel absolutely exhausted. Everything exhausts me, talking to people, thinking, showing up, just being awake. I don’t know what to do though. Most medications do not work, I follow strict sleep hygiene practices that I learnt over the years. I lie awake for hours not even thinking. Sometimes my eyes burn I am so tired yet still I don’t fall asleep. I need to see my psychiatrist but therein lies another problem. Another frustration that as a person suffering from mental illness faces constantly. Even though I am on full medical aid which I pay a fortune for they will not cover the fees because according to their rules (and PMB) they only have to pay for 21 days in a psychiatric hospital OR 15 visits with your psychiatrist and nothing more. That’s it, regardless of if you are on a hospital plan or comprehensive cover. No amount of appeals and complaints will change this but that is another argument and possibly another post for another day. Bottom line is that I have already forked out a few grand to cover additional visits to my psychiatrist and have simply run out of money. In the end, I think to myself what will it really help anyway as there isn’t really any medication she can give me to help, I have already been on pretty much everything already. Sadly, I know many others who also struggle with insomnia and it is horrible.

 

Lastly is the apathy. My sponsor asked me yesterday if I had given up and I had to think carefully about the answer. When pulling apart my thoughts the answer is yes and no. I don’t feel hopeless, I haven’t given up but I do wonder what is the point. It seems easier to just not care and keep moving forward. I know from experience that these phases pass and better times come. I know in my heart that I have so much to live for, so much love and support around me but at the end of the day I am tired and the easiest way to keep going is to not think about it too much, to not care, to just be apathetic. There are good times and there are bad times, there are times when my mental illness gets the better of me and there are times when I can manage my life and live very contently. I just need to wait it out but waiting it out is hard when the times are not good and the longer the struggle continues the harder it becomes to wait it out and not give up. I am not suicidal, I do not seek death because I know that I enjoy life, I know that I have passions and interests to still follow but right now I am tired. I am exhausted. I am simply okay.

There are so many of us out there that feel this, that find conversations too much to handle at times and sit in silence instead. So many of us that face the paradox of wanting to give up but wanting to fight because we know it will pass. There are too many of us out there that hold on to the hurt, the melancholy, the exhaustion, the apathy because there is no magic wand to make it go away. Depression is not just feeling sad. Mania is not just having lots of energy. Anxiety is not just worrying. Pain is not just physical. Thoughts are not harmless. These things make living on a day to day basis exceptionally hard at times but there are warriors out there who press on, who keep putting one foot in front of the other, who do not give in to the easiness of giving up. Today I try to be one of those warriors and keep fighting for better days, I know they will come. So please, don’t be offended if I don’t respond to your messages or if I don’t make plans with you to go out and often don’t seem overjoyed to see you. It has nothing to do with you at all and everything to do with the fact that at the moment I am too tired, too apathetic and too busy focussing on simply getting through the day. If you don’t know me and are reading this but know someone who might be feeling the way I do I encourage you to take the same message to heart. They are not trying to avoid you they simply can’t at the moment. If you are feeling like I do, let people know you are ‘OK’ and that you need the space to simply live until things get better.

*Disclaimer* My words above do not encourage or give approval for anyone to not have a medical support team around them or not take medication. I continuously engage with my counsellor, GP and psychiatrist while we try to work through this together and I remain on all recommended medication.

Losing the DESIRE…

If you have been reading my blog for a while (like close to the beginning) or are a friend, you will know that I am a recovering addict. For those that don’t, well, I have been in recovery for just over 13 years now and regularly attend and take part in a 12 step fellowship program. This has been a massive part of my life for the last 8 years at least. It has not only kept me clean but it has played an important part in giving me a new life. The work it pushes me to do on myself, the friends I have made and the acceptance that I receive on a daily basis. Over the past few weeks the topic of ‘losing the desire to use’ has come up a few times in different conversations with various people. The discussions have been interesting and led to me spending some time thinking about it, looking back and agreeing that even though I don’t know when, I have lost the desire to use (this includes drugs, alcohol, self-harming and a couple of other things as well) as well as the desire to remain ill. After getting my thoughts in order I realised this might be a nice topic to write about so here we are for this week’s blog.

When I first came into recovery and for many years after, I would still crave different drugs (see the above list and more). Any time I felt overwhelmed by emotions, the situation around me was too difficult to handle or I wanted to stick my head in the sand and be an ostrich. Using was my first port of call, it was the easiest way to avoid/escape/run away from what was going on. By numbing myself through things like alcohol I didn’t have to deal with what was going on inside and around me. Getting into recovery meant that I couldn’t do this anymore and had to replace the behaviours with better actions like phoning someone, distracting myself or getting to a meeting. Slowly over time, by working a program, I learnt to deal better with whatever life threw at me, including my mental illnesses. My new ways of coping became the norm and I found myself turning to these instead of the automatic thought of numbing myself with drugs, etc.. I slowly lost the desire to use.

Strangely enough, this didn’t mean that I stopped thinking about having a drink, it didn’t mean that I never wanted to hurt myself. These thoughts still pop into my head even now but the desire to escape this way is no longer there. When my thoughts turn to escaping by using something like drugs, etc. I immediately know I need to do the next right thing. I know that while drinking something or using will take me out of the moment it will not solve the problem and I know that I need to resolve what is going on and even better I want to solve the problem. So the thoughts of using or hurting myself become a passing thought instead of an obsessive and compulsive chain. Because I no longer desire to use these unhealthy coping mechanisms the cravings for them never stay long.

I have come to realise that a ‘craving’ is not the same as a longing ‘desire’ to use/drink/hurt. It is not a desire to escape/avoid/run away. Those desires are gone because I have learnt how to deal with life on life’s terms. A craving of something for me now is simply a thought that I can let pass through my head and carry on with my life instead of getting caught up in the obsessive patterns again. The desire to stop using that got me to my very first meeting, working steps and talking to a sponsor has morphed into a desire to stay clean, a desire to serve others, a desire to be a productive member of society, a desire to live my life more and more every day.

One of the 12 Step Fellowships, Narcotics Anonymous, says in its literature “an addict, any addict, can stop using drugs, lose the desire to use, and find a new way to live.” I think this is such a beautiful message and have seen it come true in my life. The same has applied to living with a mental illnesses, which desire rules? In the beginning, the desire to stay ill was strong. I wanted to be manic or depressed. I wanted to just avoid or run away to the clinic. Now though I have a desire to live my best life despite and because of my illness. Some days are going to be rough but as long as I let go of the desire to stay in the hole I sometimes land up in and hold on to my desire to live my best life I somehow make my way out of that hole again.

This probably applies to everything and everyone in life. Whether you are an addict, suffer from a mental illness, have a disability or are just traipsing through life we need to look at our desires. What desires do we need to lose and what desires should we hold on to? For me, I hold tightly to the desire of living my best life every day, being the best person I can every day. Sometimes I am going to fail or get it wrong, sometimes I am going to struggle to care enough but I believe that if I live this desire daily I will get through the rough moments.

I lost the desire to use, I lost the desire to stay depressed, I lost the desire to give but I have gained the desire to live, to be productive, to love and be loved. Isn’t it a fantastic thing when we can turn our desires around like that? Starting out in my recovery I couldn’t see this, I couldn’t grasp that a day would come when I would lose the desire to use and live instead. By following suggestions, doing the next right thing and working hard at bettering myself I am on that road now, that road of living, that road of life. Until next week I hope you all get to live your best life over the upcoming days.

Image by Momentmal from Pixabay

Learning balance

What a crazy, crazy, busy week it has been. Between functions, talks, training, work and events, I have barely had a chance to breathe and once again was taught about the importance of balance. The past week was mental health awareness week accumulating with mental health awareness day on Thursday. I have been involved in 2 initiatives over the past week that works hard to fight the stigmas people have of mental health. The first being the TV show, Mental Matters, that I took part in and wrote about last week in my blog, ‘And so much more made sense‘ which finally aired on Friday and you can watch that here. And then also all the Crazy for Walking initiatives that happened over the week which included plenty of walking and some interesting talks. The week also included an NA party and training happening at work. So very busy and as the week went on I started feeling more and more exhausted.

It was time for me to learn another lesson, well, re-learn a lesson I know well but often forget. Balance!!!! Living life in balance is exceptionally important for both my mental health and my recovery. It’s also important for my sanity. While I may be a people person in terms of being confident and putting myself out there I am also an introvert and too much time around other people exhausts me to the extent I can sleep for hours afterwards to recharge. With the week being so busy and full of people I was feeling exhausted and overwhelmed. Sometimes being in a good place mentally causes me to forget I need to balance out the amount of time I spend with people and by myself. Balance the relaxing times and busy times.

Understanding introverts and extroverts can be confusing and not really as simple as being the life of the party or the shy person in the corner. Belle Beth Cooper summarises it nicely in her article on Fast Company by saying” Introverts are tricky to understand since it’s so easy for us to assume that introversion is the same as being shy, when, in fact, introverts are simply people who find it tiring to be around other people.’ Read the rest of the article here for a more in-depth understanding. Being an introvert I need that time alone to recharge but because I often have a lot of fun with other people around I forget and then become exhausted and irritated because I am neglecting to recharge my own battery. It is important to understand where you fit in and what charges your battery when managing your recovery and mental health as when your battery becomes empty things start going haywire and out of control.

So, back to balance after that quick diversion. For me to remain mentally healthy and act responsible I need to be careful about maintaining balance. Not just in how much I do or don’t spend time with people but also in what activities I am partaking in. An easy way I remember the basic categories is the acronym SPICE, this stands for spiritual, physical, intellectual creative and emotional. As long as I am filling up these cups evenly and often my life remains in balance and everything stays stable and easy to manage. Now I can do any of the above with or without people and so I need to ensure that I am also balancing my activities the recharge and deplete my battery at the same time. For example, I might practice the ‘physical’ part by walking with a group of people but then work on the ‘intellectual’ part by studying a course online by myself. I can be creative with others or by myself depending on what I am needing at that moment.

So, after spending a weekend mostly sleeping (hence this blog only coming out on a Monday instead of the usual Sunday) to recuperate and recharge I need to look at my days going forward and ensure that I am balancing my life both by the activities that I am engaging in and the people(or lack of people) I surround myself with. I think the lesson is that I mustn’t be afraid of offending people or having FOMO but rather place the importance on my mental health that it deserves to have. So if you are a friend of mine or someone else who sometimes says no when you invite us out please understand that it is not necessarily that we don’t want to spend the time with you just that possibly we cannot spend the time that you have chosen because we are busy recharging or partaking in activities that allow us to live balanced lives the best we can. On the other hand, if you understand your friend’s needs well and they are always saying yes to the same thing or spending too much time alone or with others, challenge them and hear what is going on before making a judgement.

Here’s to having a happy balanced week for me and everyone else out there.

And so much more made sense…

Firstly, let me just apologise for being so quiet the last month. I was lucky enough to be travelling through the UK and experiencing a dream (maybe I will post about it one day) so didn’t have much time to do anything else. For now, though, I am back home and excited to be posting and sharing life with you all again.

This morning (a Friday) I woke up early, put the kettle on and croissants in the oven. Then I got dressed and ready to be picked up. With coffee and breakfast packed my friend and I made our way through traffic (which wasn’t too bad) to Cape Town TV studios. I was excited and nervous all at once, about to become part of something so much bigger than me, than any individual person. A number of us were all going to be interviewed by the new series called Mental Matters for episodes 4-6. I wasn’t sure what questions were going to be asked and who I would be sharing the stage with but I was excited that there were others out there like me that were willing to be vulnerable and open about their mental illnesses because it was important to share with others. I knew I could do it because the message was important to me and I had watched others put themselves out there already. (You can catch the episodes on Depression, Anxiety and PTSD/Complex Trauma if you are interested.) Because I am such a clusterF*** of mental disasters I actually didn’t know what my topic was for the interview until late last night but as I feel quite comfortable with many of my diagnoses I wasn’t too worried. Until they said I would be looking at my OCD, wait, what!! And the freaking out began.

This photo was taken by Luke Sadler at the Mental Matters Studios

I was only diagnosed with Obsessive-Compulsive Personality Disorder at the beginning of this year while I was in a psychiatric hospital during a Bipolar episode so I really didn’t know or understand that much about it yet. Freaking out was an understatement. If anybody knows me at all they will laugh when I say that the next thing I did was open my DSM-IV to get the pivotal information quickly. I had a broad idea from when my psychiatrist and I discussed it and she made the diagnosis but because so much as has been happening this year I didn’t research much further. I cannot underplay how much I hate being unprepared and how panicky I get when I don’t have knowledge about something and need to share it. So with the DSM-IV in one hand and my computer open on Google I began to learn about the illness that I was attributed with and as I read so much of my life began to make sense. So many of my behaviours, thoughts, patterns were laid out on the pages in front of me. Things that made perfect sense and were normal to me being written in words in a book under mental illness, maybe I wasn’t as insane and difficult as I thought I was.

Now, many of you have probably never heard of OCPD before and those that know me will always have attributed so many of my behaviours to OCD but these two things are not the same. According to OCD-UK “Obsessive-Compulsive Personality Disorder (OCPD) and Obsessive-Compulsive Disorder (OCD) sound the same, and are often confused and mistakenly interchanged as being the same illness, but notwithstanding similar names, they are in fact two separate conditions. Whilst OCD is considered an anxiety disorder, OCPD, as the name suggests, is actually a personality disorder. It’s also possible to suffer from both OCD and OCPD simultaneously.’ Read more here from this article.

Let me outline the symptoms of OCPD for you quickly from the DSM-IV:

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

1. Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.
2. Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met).
3. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).
4. Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).
5. Is unable to discard worn-out or worthless objects even when they have no sentimental value.
6. Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.
7. Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.
8. Shows rigidity and stubbornness.

I find it very amusing that the last post I wrote was called ‘A record of my lists‘ where I outlined all the different types of lists I often made and how they help me and then looking at the first criteria for OCPD being preoccupied with details, rules, lists, order… I really am obsessed with these things and always have a spreadsheet or list to organise and keep information. I cannot function at an optimal level if I do not have these and will often spend hours putting sheets together. Although my perfectionism has improved I still struggle to accept that what I have completed is good enough and will redo thing multiple times trying to make it perfect, wasting time and resources in the process. I remember when I started doing Narcotics Anonymous stepwork I would rewrite my answers every time I made a single mistake even if I was at the bottom of the page. I have since learnt that it is far easier for me to always type things and print them rather than write something out. I live by my own set of rules that don’t make sense to other people and don’t apply to other people. In counselling, I will often get asked if I would expect the same from others and my answer is always ‘that’s different’ because the standards and rules I have for myself are not for other people. When I don’t live up to them though it makes me unworthwhile or not good enough. My friends and family will tell you that I am definitely over conscious and inflexible about many matters. I get exceptionally upset about unfairness and want to go in with fists blazing. I get passionate and come across aggressive because of this firm belief in matters. Many of the above criteria absolutely apply to me and as I read more about OCPD more about my thinking style and behaviours make sense.

While I was in the studio being interviewed I had a realisation which left me feeling heavy inside and sad. I realised how many people have walked out of my life because of my mental illnesses, not just my OCPD but the Borderline, Addiction, Anxiety and Bipolar as well. People that found me too much hard work or didn’t want to put up with my idiosyncrasies anymore. I will admit, I am a difficult person to be around, I apply strange rules about where things must go and how things need to be done. I struggle to make small talk and am not good at socialising but I try, really I do. I thought I hadn’t faced too much stigma against my own mental illnesses but it was pointed out that stigma is not just what people say but also what they do. How many others out there suffer from their mental health and only receive rejection and judgement. Hundreds I tell you, thousands, millions, probably every person who struggles on a daily basis faces these stigmas. Sometimes from the people around us and then because of what we have learnt even from ourselves. How sad, how unfair that millions of people around the world cannot and do not feel safe even in their own homes. That struggle to surround themselves with people who care and support them. I have been lucky, my family slowly came to understand some of the difficulties and help as much as they can, I have managed to find some friends who listen and learn about the illnesses I have and don’t walk away but I am one of the lucky few.

People who struggle with mental health issues do not need to just ‘pull their socks ups’, ‘have more faith’, ‘get a grip’. They need support and care as they face difficulties that others do not understand, cannot understand. Difficulties that are not always their fault, difficulties that they work on all the time to overcome. So here is my challenge to everyone reading this blog, whether you have a mental illness or not, go out and fight the stigma that we face, go out and learn what you can to help those around you that are struggling, go out and make others aware that stigmatising mental health is not how we help. There are organisations busy doing all of these things (Crazy for Walking, Cape Mental Health, Mental Matters, No Stigmas Network) but it’s not enough. We need more people out there learning, understanding, fighting for those that do not have the strength to fight for themselves.

I also want to say though that for each of us with a mental illness, we also have a responsibility to engage, seek help, take our medication and work on our recovery. It is important that when we can we take responsibility for looking after our mental health. Here are some support groups available around the Cape Town area that you can look into. If you are outside of CT and have some more links for me please leave them in the comment section and I will add them.

Healing Spaces CT – runs a monthly support group and weekly Mindful Movement group

SADAG – runs bi-monthly support groups

Bipolar support group – runs support groups bi-monthly

I hope that the blogs I am writing and posting about my life, the mental challenges I face and the experience I have are helping even one person to know that they are not alone or someone else to realise that they don’t need to walk away because a friend or family member is being difficult. I hope you have gained some insight into what someone you know may possibly be facing. If you have ideas or subjects you want me to cover please leave them below in the comments section. Until next time, happy fighting.

A record of my lists

Having a mental illness is not a joke, it’s not made up and it’s not easy to live with. Whether I am flying high in hypomania or sinking to the depths with depression I am not thinking rationally. The tools that I have learned over the years are forgotten as if I never knew them. This puts me in a difficult position because I need those tools to bring myself down or pick myself up. Without them, I get swept away into other worlds that begin to be difficult to get out of the longer I stay there.

I think this is a common problem in people who struggle with mental illness. It definitely holds true for the various aspects of my mental illness. Even in my anxiety, I start to lose focus of the goal and begin to panic more. I forget to breathe, reality check and start obsessing. When symptoms of our mental illness get worse it’s almost as though we get trapped in our head at that moment and forget everything else. Think of it like this; life is a boat on the ocean and my various mental illnesses are a fishing net. When I get thrown overboard by a big wave (meds not working, bad day, circumstances) I get wrapped up in the fishing net and am unable to swim back to the boat (life). It’s right there, not even 3 meters away but I can’t get there and the longer I don’t swim back, the further away I drift, the harder it becomes to get back, and a vicious cycle begins. I need help to get back, someone to simply reach out their hand or throw a rope. So how then do we get back to the boat if there are no hands reaching out or ropes being thrown?

For me, well I write lists. Lots and lots of lists. I have a list for pretty much every situation or feeling. I don’t need to use them as much as when I originally made them but they are all still around in notebooks for when I need them. Lists tell me what to do when my brain is not working correctly. They let me know what the next right thing to do is when I can’t remember. These lists have saved me time and time again from spiralling higher and deeper into my ups and downs. Some of the lists are steps to follow, some are checklists, some are more tangible with actual items and some are just lists of information, but each of them has helped me get through dark moments and bring me back to reality.

Photo by Glenn Carstens-Peters on Unsplash

I thought I would give you some examples of my lists below for if you ever wanted to put your own lists together or maybe help someone else do it.

Distraction and soothing lists

Because of my Borderline Personality Disorder and the Bipolar I often need to distract myself from the feelings I am experiencing because they become so overwhelming. For this, I created a distraction box with a list stuck on the inside of everything there. I put in things that would take my mind off the panic I was feeling, the urge to self-harm, my irritability or any of the overwhelming feelings of distress I was feeling. Creating the box was also a great process. First I found a nice sized box and decorated it. For me, it was a collage of images that I wanted to achieve one day or that made me happy. Then I filled it with items like; a movie (one that made me smile and one that made me cry), a scented candle (vanilla as it’s my favourite scent), something to do with my hands (I put in my beading tools and some beads as well as a deck of cards), a USB (with 3 playlists – for mad, glad, sad moods), an envelope with R50 (so I always had money to go for a coffee if I needed it), etc. You would need to figure out which items would help you and calm or distract you for yourself. I used this box so many times it became worn and I had to replace items in it but it worked every time. To see how to build your own distraction box, check this article out.

Sometimes though, I need more soothing than just distraction so I also put together a self-soothing box. This box was a lot smaller and could actually fit in my bag to carry around with me. You can make it so small it fits into a matchbox. A great way to soothe ourselves is to use our senses so I put together a list of actions to take that engaged with my 5 senses. Then I cut each of the actions out, mixed them up and popped them into a little box. Every time I started feeling distressed I would grab my box, pull an action out by random and do what it said. Some of my actions were; going to a park and playing like a child, lighting a scented candle, slowly eating my favourite food or sweet, going for a massage or haircut, or listening to some music. As I engaged my different senses I calmed down and felt better. For some more examples of self-soothing actions and putting your own kit together you can have a look at this article but remember to put some of your own in there. Things that make you feel better, calmer and loved. For instance, having a haircut is always on my list because it brings memories of my gran back and I love the sound and feel of the scissors cutting my hair, for me, this is really soothing and always makes me feel better.

Doing the next right thing lists

These are lists that I put together and paste all over. They tell me what to do next, a list of steps to take when I can’t think of what I need. One of the lists I keep handy is the names of people I need or can call. It’s just a straight-up list with 20 names. Top of the list is my sponsor, then another name, and so on. The rule is that when I start to panic or want to do something stupid I start at the top of the list and work my way down. Only once I have tried all the names do I have permission to act on my thoughts. I also have a list of actions to follow when I am deep in depression, a checklist of sorts. Make your bed, brush your teeth, have a shower, eat something, take your meds, leave the house, get dressed. This type of checklist keeps me moving on a daily basis and often helps me not sink even lower into the blackness. I also have lists to help me manage my mental health and recovery that I try to keep to, things like attending a 12 step fellowship meeting a week, going to mental health support groups, seeing my counsellor regularly, etc. Lists like these help me keep on track with life, keep me in check and keep me from acting out or doing stupid things. Some of them are stuck around, some are in books and some are hidden away for emergencies. In the beginning, these were the most important lists but over time and as I used them over and over they became habitual for me. I don’t actually need the pieces of paper as much any more as the lists are ingrained in my head now. I have used them so often they have become second nature which is really helpful in moments when my brain switches off.

Managing anxiety lists

Anxiety and panic attacks can often be the most debilitating and paralysing things to experience. Lists with actions, distractions and soothing techniques can be of tremendous help in these moments. One of my biggest anxiety provokers is lateness, for myself or others. I suppose when people are late it brings about fears of being forgotten or abandoned. To help me get through it and avoid a panic attack I follow a list of instructions. They go something like this if I am getting picked up at 3pm and the person is not there yet I have to give them 5 minutes (there could be traffic or something), then I need to send a message – if they have not responded within 5 minutes to that I am allowed to call them. Normally I would then find out what is happening and the time is readjusted and panic averted. If there is no answer I need to allow for 5 more minutes and then call again. After following all of these steps with no resolution I am then allowed to panic. In over 13 years I have never actually reached the ‘allowed to panic’ stage of my list. Having lists like this acknowledge the fears and anxieties but also put in some actions before allowing it to take over. I also know that I panic when having to make big decisions or make changes, I become terribly overwhelmed and anxiety kicks in. Once the anxiety kicks in I am useless and no decisions or changes get made. So I follow another list of suggestions. Firstly, no thinking about it for longer than 20 minutes at a time. Often writing a list of pros and cons will also help. Sometimes I call my mom and chat it through with her. Other suggestions on the list are doing a bit of research, planning the change on a piece of paper or mapping it out and distracting myself when I start to feel overwhelmed until I am calm again.

To even begin putting these lists and suggestions together, I have to start by becoming aware of what my anxiety triggers are. This is hard in the beginning but by trying to be more aware more often it becomes easy to pick up what things or thoughts are triggering my anxiety. Once I have this list (and I can continue to build on it and add changes) I can start thinking through what will help me in each of those situations. These lists are the hardest to put together and I had my counsellor help me with many of the first lists I put together. She gave me suggestions for the lists and helped me work out where the triggers were coming from. It’s important that you allow people around you who know you to support you through putting these lists together. It’s also helpful to speak with other people and see what has helped them manage their anxiety. Listen to everything with an open mind, take what you need or might help you and leave the rest behind. Everyone is different so what works for one person might not work for you but if it possibly can then it’s worth trying. Putting together the distraction box and soothing kit will also help and be handing to have around for when you do start having panic attacks.

Informational lists

These are really simple but can also be life-saving. I have a list written down with all my support teams information, so email address, telephone numbers (office and cell if possible), addresses and office hours with emergency numbers if they have. I keep this for my counsellor, psychiatrist, doctor, sponsor and preferred hospital. It’s handy for me to have when I can’t think but it’s also handy for the person helping me to have if I am incapable of thinking due to an accident, unconsiousness or psychosis. I have another list with all the information for support groups and helplines in the area. There is so much information out there and so many different support groups available that I think it is really important to make a list with the information. For instance, I know that in my area there is a SADAG meeting twice a month, a Bipolar support group once a month and a mental health support group once a month. I have the times, dates and addresses for all these meetings. I have telephone numbers for all the hotlines and a meeting list of all the various 12 Step Fellowship meetings in the Western Cape. I also have information for several other helpful things like Crazy for Walking, which I join most months and ongoing groups or classes for things like depression, anxiety, self-esteem, art classes, etc. Some of these are free and some are paid for but they are handy to have.

Here are some sites where you can find this information:

• SADAG
• Bipolar Support Groups
• Crazy for Walking
• Healing Spaces
• Cape Mental Health
• NA Meetings | AA Meetings | CODA | SLA Meetings

(Please note that these are mostly in South Africa and Cape Town but I encourage you to find out what is in your area)

We all have different ways to work through and manage our mental health, writing lists has always helped me tremendously. I hope that you have either found some of these helpful or been encouraged to find out what might work for you. When we struggle with a mental illness it is important that we look after ourselves and put everything in place that could help us daily. Do the work, spend the time preparing and the extreme highs and lows might become more manageable or at least you might become aware more quickly that you need to reach out to your support team. Please comment with any further suggestions you might have, we have to stick together and help each other as much as we can.

When depression isn’t depression

“Today I remembered you, the man you used to be. Today I remembered you, the man that I once knew.
I lay awake for nights on end, the sadness overwhelming. I didn’t want to move at all, my heart completely broken.
In a box at the back of my mind, I packed the pain away. In a box far away, I held the feelings at bay.
With every second, minute, hour, life seemed to move on. For one day, one week, one month, it never seemed to end.
You lived your life until the very end, you gave up too soon. You were my family, you were my friend.
I lost you to natural causes, I lost you to yourself. I didn’t find it fair when God took you both.
It absolutely terrifies me, causes me to panic. The grief I feel inside of me is no longer silent.
Today I allowed myself to feel the pain of loss. Today I allowed myself to acknowledge I feel lost.”

For the last few days, I lay on my couch staring into nothing. Series playing in the background until the early hours of the morning. Awake, yet exhausted, sad but numb. I didn’t understand, I thought I was sinking into depression again. I didn’t want to see anyone, go anywhere or do anything. I just wanted to lay there and ignore the world. The feelings so overwhelming I found myself retreating into myself, drawn into the nothingness. My moods have been so all over the place from hypomania to depression and everything in between that it made perfect sense I was just moving towards depression again. I accepted it, lived in it for a while and then went to see my counselor. All the signs were there, the low mood, eating junk, feeling tired all the time, not being able to sleep, isolating myself, I didn’t know it could be anything else. Except, my counselor disagreed and talked to me about grief. She explained her thoughts and told me that she is not surprised I am finally feeling this way.

This year I have handed over 2 clients that I worked with for over 2 years, had a severe Bipolar episode and landed up in a psychiatric hospital,, lost my grandfather to a heart attack, gotten a new flatmate, suffered massive mood instability, had a friend commit suicide and been to 3 funerals all by July. It’s been a rough year at best. Through all of this, the major thing I have concentrated on is getting my moods stable again. I felt sad at times, cried here and there but really I have just been trying to get through each day without killing myself or someone else. I haven’t had time to grieve anything, I don’t even know how to grieve. The last time I lost someone important to me I was still in active addiction and didn’t know how to feel. That was thirteen years ago and I have never learnt how to since. I have lost jobs and friendships, moved house and experienced the death of acquaintances but I haven’t really needed to grieve, I’ve just kept moving forward. So when all these feelings came on I had no idea it was simply grief and sadness, not depression.

Depression I can deal with, it feels crap but there are things that I can do. See my doctor, change my medication, talk it through, go to a meeting, things I can do. Grief through is different, there is nothing that I know how to do to make it better. To take away the feelings that are overwhelming me. I have spent years learning about my Bipolar, the mania, and the depression. Learning what to do next, learning the symptoms, learning how to push through. I have made hundreds of lists telling me what to do when I can’t think in those moments. I have surrounded myself with a professional team and a great support system. Depression I can deal with. Grief is new to me, I don’t know what to do. I have sat on my couch for days, listless and lethargic. Watching series and silently crying because the tears won’t come on their own and I need to get them out. Eating all the time to try and fill the hole that is somewhere inside of me. I am sad, very very sad and I don’t know what to do with it.

When I told my friend the other day that it felt like it would never end, she responded with this; “Honestly, it does not, but the rest of life kind of surrounds it and gives it a hug so that it only hurts sometimes.” This brought a little bit of warmth to my heart, it sounded real, something worth hoping for. It’s a strange thing grief, I don’t want to feel this way but a little part of me feels that if I stop feeling this way now then I didn’t love these people enough. I miss my grandfather and I miss my friend. Sometimes I miss the clients I handed over. I miss my old housemate even though I love my new one. And I miss just being okay for a little while, I am tired of losing things this year, tired of struggling. So I have realised that I have plenty of reason to be grieving, I am allowed to finally let everything from this year catch up and it’s okay to be sad for a little while. It’s hard, it’s overwhelming and it’s difficult but it’s okay. Grief is part of life, losing things and saying goodbye are part of life. This is new for me but it’s a lesson we all need to learn and I think I am ready to start learning it.

The good, the bad and the ugly of medication

Medication for mental illnesses is a controversial and complicated subject. While not a psychiatrist, or any kind of doctor for that matter, I believe that after being on some form of psychiatric medication for the last 20 years I have a good idea of all the different reasons to take and not take them. I have argued with myself, my doctor and other people about them many times. I have seen the amazing effects of them and suffered the awful side-effects from them. It’s important to note that what I say below is only my experience of medication and the medication that I have been on. There are hundreds of various types of medications and hundreds of more generics of those same medications. Some work the same, some work differently, some are used for different aspects and sometimes you have to use more than one on the same aspect.

I have been on so many different types of medications, first for depression, then borderline personality disorder, then bipolar and sometimes for anxiety. I have tried and tested over 30 different medications since I was 19 years old. Some worked, some didn’t, some worked and then didn’t, some didn’t and then did and some still work. As I said, it’s a complicated mess and that’s why we pay psychiatrists the big bucks to prescribe them. They need to know which medications are better for different symptoms, how they work together with each other and any other type of medication you might be on as well as how you might negatively be affected.

So here are the various categories that I know of: anti-depressants, anti-psychotics, anti-anxiety, mood stabilizers, and stimulants. Anti-depressants are most commonly used to treat depression but can also be used for anxiety and insomnia. They are normally divided into 2 categories – selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Anti-psychotics are used to relieve symptoms of psychosis (often occurring in bipolar 1 and schizophrenia) but can also be used to help with PTSD, ADD, eating disorders and depression. Anti-anxiety medication is obviously used to reduce anxiety, fear, and worry. Mood stabilizers help keep moods more stable for people who have bipolar or some personality disorders. It has been found that anticonvulsants (medication for seizure-related disorders) in varying doses work very well as mood stabilizers. Lastly is stimulants, these are mostly used to increase alertness and attention. Commonly used for ADHD but also for narcolepsy, and occasionally depression. For precise information on the breakdown of various psychiatric medication check out this article.

So now to the good, the bad and the ugly of medication. And all of these sides co-exist, medication is not just good or just bad. Sometimes it’s amazing and other times it’s downright horrendous. I took anti-depressants for years with only slight alleviation, then I landed up in a psychiatric clinic had all my medication changed and put on 30 kilograms in just over a year. The new meds worked though and I felt better, I didn’t even notice the weight gain until later. Unfortunately, after about a year on the medication, it stopped working and I slipped into a bad depression again and had to go back to the hospital. For the next 5 years, I was in and out of the hospital with my medication changing every 12-18 months. Then we figured out the mix that worked for me and things settled down, only I slowly continued to pick up weight. Some medications made my joints sore, some left me with a dry mouth and some made me itch. Mentally though I was moving forward, I was learning to manage my mental health and my moods started to stabilize.

One of the hardest things about any type of illness where you have to be on medication for long periods of time is the feeling that you don’t control your own life. That the medication is controlling you, that you cannot just go out and live your life. Every morning or every evening, sometimes 3-4 times a day you have to stop what you are doing and take your medication. You have to always remember it when you go away or sleep out. More often than not you can’t take them without eating first. And you have to acknowledge that you can’t live without them, they control us. Sometimes you are forced to get a certain amount of sleep or you always have to be home by a certain time to take them, sometimes you can’t drive afterward and sometimes you can’t just wake up when you feel like it because you have to wake up with enough time to take them and let them take effect before you can leave the house. I often feel like they are controlling my life and it frustrates me but I know I need them and that frustrates me even more.

The other thing about so many of these medications is the awful side-effects you often get. Like I mentioned earlier I put on a lot of weight. This was mostly from the anti-psychotics and some of the anti-depressants that I was on. I’ve never been super thin but I have always been athletic and after putting on so much weight I was no longer comfortable in my own skin, I wasn’t comfortable walking around let alone running around. I wasn’t comfortable showering and everything became harder to do. I became tired and sore all the time. Some medications make me drowsy after I have taken them in the morning but have no effect in the evening. I have fallen asleep at my desk, in busses and sometimes before I could even get to work. People don’t understand this, they think it’s my fault for not sleeping enough and don’t believe me when I say that I have. I literally could not keep my eyes open which was particularly hard when I was traveling through Lesotho for work and holding workshops every morning. Some people completely lose their appetites, others yawn continuously and others still struggle to sleep. I often get exceptionally restless when the dosages of some medication increase too dramatically. My legs move so much it stops me from falling asleep at night. Basically, the side-effects are so varied and plentiful you really can’t be sure if you will be affected or not. More often than not you just have to stick it out for the first 3-6 weeks and then they slow down but sometimes not.

So why then, through all of this, do I continue to take my medication? Because even in the ‘uncomfortability’ and frustration I am very much aware of how much worse it could be if I wasn’t taking any of these medications. Being on medication for my mental illness, along with some hard therapy work, has changed my life. It has allowed me to live, if not a ‘normal’ life, then at least a manageable life. A life where I do not lie in bed all day every day for months on end, or spend thousands of rands on useless things. Because, no matter how hard I worked, pulled my socks up, decided to be happy, I wouldn’t be able to do it by myself. I need to be on my medication to function daily, to successfully hold down a job, friendships and be productive. Even though I go through moments of arguing with myself, of wanting to give up I know that being on medication makes my life better in the end. So, knowing this, I am then happy to go through different medications, the awful side effects and the frustrations it brings. I am happy to follow my doctor’s instructions explicitly because, at the end of the day, when you find the right combination, medication works for the most part.

So, there it is, the good, the bad and the ugly according to my thoughts about medication. It’s hard at times and it’s frustrating but I wake up in the morning with the motivation to get out of bed and I feel grateful. Sometimes I am sore and tired but other times I find great joy in being able to go out with my friends and just be. I hate the fact that I have to be on medication, probably for the rest of my life, but I am happy to keep pushing through because the benefits far outweigh the effects. Each person has their own experience and this is the only mine.

When dreams become goals

In just over a month I will be on a plane to England. Something I have dreamed about for over 10 years. So when did my dream of going to England become a goal and how did that happen? What did I do to finally make this dream a reality?

I’m not sure when or how this dream began but about 10 years ago I went and renewed my passport with the hope of traveling to England. At the time it was a distant dream, a hope, a fantasy. I had no funds to pay for it and no plans to get there but I wanted to make sure I was ready to travel if the opportunity came up. It was a passive dream, something I hoped someone else would make a reality.

 

I have wanted many things in life, had many dreams and I have achieved quite a few of my goals. Recently though, I realised that my dreams only become reality when I turn them into goals. When I become serious about wanting to achieve them and put plans into place. I realised that I could want something but not actually want it enough to do anything about it.

This was the England dream, I wanted to go but not enough to actually do anything about it. I wasn’t willing to sacrifice day to day things so I could save money. Not enough to make plans and put them into action. When thinking about it, this is exactly how so many of my dreams fizzle out and die. I don’t want them enough. Yes, I’ve had some struggles, yes, the time hasn’t always been right but unless something happened that made going to England more important than anything else I was never going to actually get there.

I think that the same applies to many things in life. We want and want but aren’t willing to put in the action. It definitely applies to my mental health. When I first got depressed, of course I didn’t want to feel that way but I also didn’t want to do anything about it. I fought telling anyone, I fought going to see a professional and I fought taking any medication. I walked around for years feeling depressed and suicidal. I hated life, I hated everything around me and I hated myself.

It took years before I eventually landed up in a psychiatric hospital and then a few more years before I finally took some action. Now 10 years later I see the results of all the action I have put in over and over. I see the results of healthy coping mechanisms that have become second nature. If you have been following my blog posts you will know that this has been a rough year for me concerning my mental health. I’ve had some really bad days and weeks, but days and weeks are nothing compared to the months and years I had in the past.

Not even 2 weeks ago I was so depressed I was suicidal. I had lost all hope and motivation to keep living. Previously this would have stayed for what felt like forever. Not this time though, not even 2 weeks later and I am feeling more balanced again. This is only because after years of action I continued to do the next right thing even when I didn’t want to. I often speak about my gratitude to God and others but I am also grateful to myself for never giving up and putting all the hard work in over the years.

When I first started struggling with mental illness I wanted to get better, I dreamed of a day where I would feel almost normal, but not enough for that dream to become a goal. It was a passive dream, I wanted someone else to achieve it for me. When it did change to a goal when I put in the action, the goal didn’t become reality overnight, it was many more years of hard work and never giving up (believe me, there were moments when I wanted to). Now more than 20 years later I still have a mental illness but now it’s mostly managed. The good days far outweigh the bad ones. I can’t tell you exactly what changed for me and when this dream of being better became more than a dream. I can’t tell you how or why I started wanting it enough to make sacrifices and I can’t tell you the exact plan of action I took to reach this point.

What I can tell you, from my experience, is that it happened. The fear of staying where I was stuck overrode the fear of doing something different, it overrode the fear of doing hard work and it overrode the fear of failure. I picked a course and stuck to it despite wanting to give up, despite the emotions that rose up and despite the pain I was feeling. I reached a point where I wanted to get better so much that my dream became a goal. You will have your own reasons for not wanting it right now and your own challenges to face but I wanted to say it’s worth it in the end.

The England dream became a goal when one of my longest and best friends told me he was getting married. Suddenly it wasn’t just about going to England it was about supporting my best friend on one of the most important days of his life. The dream became important enough that I made it a goal. I gave up coffees and dinners out. I gave up the nice things I didn’t need and I saved. I put time into planning and that dream is now a reality. The goal has finally been achieved.

What is the turning point for you to turn your dreams into goals, to let them become realities? Do you want it enough, are you willing to make the sacrifices and put in action, the hard work required? You will know when the time is right, and then you will succeed. Your dreams will become goals and eventually a reality. Good luck.

Walking through the darkness

It felt so sudden, like one moment everything was fine and then the next moment it wasn’t. Looking back and trying to figure things out I realise that maybe it wasn’t so sudden. First was the irritability and sensitivity, taking things too personally and becoming frustrated. Then was the anxiety and a slight feeling of panic. Next came emptiness, blackness, ‘the darkness’. No, it wasn’t sudden at all, it had been building up for days.

So when did my world suddenly become dark again? When did I leave the light and start walking in the darkness? I think the day I heard my friend had died, the day my heart broke a little, the moment in which my hope was pulled away. The first response was tears and terrible sadness, disbelief that I was never going to see him again. Then anger at addiction, depression, him and God. By the time evening came, I was numb inside. The next morning I couldn’t concentrate and all my moments with him came to mind, the conversations, outings and I was again filled with sadness. That’s when I wrote ‘Leave the light on‘ after which my emotions settled down again. I thought the grieving was happening but I was just getting number inside.

The big turning point came when I started to feel guilty and jealous, then shame about being jealous. Jealous that he had cheated life and I was still living. Jealous that he chose to leave this world and I had to stay. I tucked the jealousy away and focussed on the guilt. Guilt that I had been too busy for the last 3 months to spend time with him when he was trying to make plans with me. Guilt that I was so wrapped up in my own mental health struggles that I forgot about his. Guilt that I wasn’t there for him. But people told me that I shouldn’t feel guilty, that it wasn’t my fault and so the jealousy moved back in and I got angry. Angry that I couldn’t follow in his footsteps and ashamed that I even wanted to. The mess of emotions from the weekend reached critical on Monday when I was finally exhausted. Tired with living, tired of fighting a losing battle, tired of being optimistic, tired of never giving up, just tired. I didn’t want to do this anymore, I didn’t want to fight anymore, I didn’t want to live anymore.

I became obsessed with dying, obsessed with giving up and letting go. But I couldn’t commit suicide, the recovery wolf was too well fed and wouldn’t let me. So then I became obsessed with self-harming because if I couldn’t kill myself then I needed to get rid of the feelings I was having and self-harming would help but again the recovery wolf was too strong and all I got left with was a spiral into darkness and the inability to act on any of it. I couldn’t stop the feelings, I couldn’t get rid of the blackness and I couldn’t get rid of myself. Much to my dismay, I kept doing the next right thing. I called my sponsor, who told me to contact my counselor the next day. The next day I managed to get an appointment with my counselor who set up an appointment with my psychiatrist, who I eventually saw 4 days after the darkness entered. Through every conversation, appointment, and explanation my anxiety rose. I was so anxious I felt sick inside. I wanted to purge, get rid of every feeling and thought inside of me. I am so very grateful for this time I have spent in recovery that has taught me to just keep doing the next right thing. This recovery that has fed the recovery wolf year after year making it stronger than the dark wolf at this moment. I am so very grateful that over the years I have picked up the most amazing friends who stand by me even though I don’t want to talk about it or be around anyone. I don’t feel lonely and I don’t unloved. I just feel broken and defeated, I just feel tired and hopeless, I just feel like I can’t any more.

6 days later I have woke up for the first time feeling a little less anxious. Today I can look back on the week and feel compassion for myself, not a lot, but a little. For this moment, I have a little bit of hope in me once again. So far, I have spent just 1 week walking in the darkness and I have no idea how long it could last. I could wake up tomorrow and feel a little less bleak or I could wake up tomorrow further down the darkness. I am terrified of falling deeper and I am terrified that my recovery wolf will weaken as the dark wolf grows stronger. I can’t focus on that right now though. I need to concentrate on this moment where suicide is not consuming my thoughts and be grateful for the brief respite. I have lived days, months and years in the darkness. There are people all around me who continue to walk in the darkness every day and never give up, I need to be one of those people. At the moment I hate my recovery, I hate that part of myself that is keeping me alive but I know that tomorrow I will be grateful for it. I will be grateful I never gave up and I will be grateful that I didn’t do anything to harm myself. If I can’t make it in this moment, I am holding onto that moment. That moment that will come tomorrow or the next day or the next.

If you are reading this and know me personally please do not be alarmed. Yes, I am struggling, but I am doing all the next right things. I am in contact with my psychiatrist and counselor, my medication is being looked at. My friends are around me and supporting me. Plans have been made for if I get worse. So please, do not worry.  I have beaten this before and will beat it again and again as many times as it takes. Please feel free, if you absolutely must, to contact me for reassurance. I am not fine but I will be. I share this post because there are many people out there also walking in darkness, it is an awful place to be. I write this to remind myself that I am not alone and to let you know that you are not alone either. I am comfortable with my mental illness and I am comfortable sharing how I am feeling not to shock people or get attention for myself but rather because people need to know this is a reality for both me and others. You don’t need to fix us, we mostly know what we need to do. What we need from you is understanding and just for you to be there.

Just for today, I will continue to do the next right thing even though I don’t feel like it. Just for today, I will keep talking about how I am feeling so I don’t get lost in my own world. Just for today, I will surround myself with people who love me and my treatment team. Just for today, I will hold out for better days.