annwfyn: (Mood - post-manic comedown)
[personal profile] annwfyn
So, recently I wrote a piece on social media for #timetotalk2017, in which I talked about my mental health, and mostly ended up talking about recovery. A couple of people were terribly nice and said they were impressed by the extent to which I seemed in control, and how far I’d come.

And, after wobbling for a day or so about how I don’t feel impressive at all, I decided maybe it would be helpful if I wrote up the stuff I’d done to keep myself sane. This has all come from conversations with Jez, with my psychiatrist, and my CPN, and is written up in various forms as a care plan, and a keeping well plan. My psychiatrist has also said nice things about my methods, so I figure they aren’t totally random and arbitrary.

Of course, this is a plan that works for me, and my particular brand of crazy. I don’t promise it will work for everyone, or will even work for me all the time. And most of this is stuff you may already have thought of. I’m not setting myself up as a font of all wisdom. But I figured the top ten things that have kept me upright and walking around might be worth writing down.

So, here they are.

1)      Medication. This is the really boring bit. Pills. Stupid, horrid pills that give me muscle spasms and make my brain fog up, and make me feel stupid and haven’t been great for my weight. Pills. My love and my hate. And also, apparently, the foundation of my sanity. Remembering to take them is a bitch. I slip and fall periodically and probably always will. The only thing that I’ve managed to do which stops me from being a total fuck up is taking them at the same time, every morning, when I shamble out of bed. They live in a bag by the sink where my toothbrush sits. Brush teeth. Brush hair. Take pills. Don’t think about it. Take them and go. I’d much rather not do this bit, but upon reflection, they beat hospitalisation. So I keep trucking on.

I’ve had my medication adjusted a fair bit over the years, so one of the few bits of advice I would give on learning to live with medication is to be proactive. Tell your doctor what side effects you can live with and what you can’t. Ask for all the facts, say what works.

I take lamotrigine and aripiprazole because they do not have ‘cognitive slowness’ as a common side effect and I was quite clear that I wasn’t OK with becoming stupid. I have a small supply of diazepam and zoplicone which means if I start to get poorly, I’ve got instant access to meds which help my control the symptoms and get myself back under control and my psychiatrist trusts me to always have 7 days supply because I do take them very sporadically. And I have argued that I am not happy at having that safety net removed because I feel it places me in danger.

If one medication doesn’t work, go back and ask for something new. You’re the patient. It’s your body. Take control. Most doctors I’ve worked with have been very good about this because I’ve been clear I am working with them to come up with a solution which works for us both. Except once when a nurse said I wasn’t allowed diazepam anymore and I had a tearful breakdown in her office, and sounded like a crazed junkie. But mostly they’ve been brilliant and understanding when I’ve wanted to discuss adjustments.

2)      A carefully worked out list of my triggers and a series of coping mechanisms which no one else can take away from me. This is the first of my slightly idiosyncratic coping mechanisms. Something I had a revelation about a while ago (and may have taken a bit far since then) is that I cannot rely on anyone 100% to take care of me. I’d say there are maybe 3 or 4 people I can trust 80%. But that’s about it. It’s not that people are bad, but people have their own priorities, and interpretations, and blind spots. However, I can rely on _me_.

I can rely on me to work out my triggers for a start and be entirely realistic about them. First of all, I would like to say quite firmly that none of your triggers are wrong. There is no moral value in what triggers the crazy, and that goes both ways. Nothing is intrinsically bad just because it’s a trigger. It just _is_. I’m very lucky in that my biggest trigger (and warning sign) is sleep related. I reliably go crazy if kept sleep deprived for more than about three or four nights in a row. I’m also a bit of an insomniac. So I need to manage this. I need a quiet private space where I can lie down and not be disturbed for a minimum of six hours per night. Dorm rooms are OK, as long as no one is running around, making lots of loud noise, shagging on the bunk above, or trying to shake me awake. The corner of a crowded crew room where people are still trekking in and out to get kit for linears at a LRP event is not OK, as an example. And if I know I have to be up at 9 am, then I really need to be lying in bed with my eyes closed by 3 am at the latest and ideally 2 am.

I also have irrational and unfair triggers too – I get genuinely terrified as trains approach. It’s one of the few things that can still trigger a proper panic (not anxiety – proper panic) attack. So I tend to try and plan my transport carefully and if I know I’m going on the London Underground, I take diazepam with me. The key here is that I work very hard to try and remind myself that no one else is going to manage my triggers for me. My issues are not your problem.* If I start relying on anyone else to help me manage my triggers, I’ll get upset and angry if they don’t, and that’s not fair on anyone. So I try and assume that every single coping mechanism I create should be capable of functioning perfectly if every single person in the room thinks that I’m a spoilt princess and that triggers only exist on guns.

3)      Access to clean, tranquil and ordered space at all times. This is sometimes harder to arrange than others, but it is really important. Basically, one of the earliest warning signs that I’m going crazy (and this particular symptom only gets worse as the crazy increases) is that I overreact to stimuli and the less time I have to process, the worse the overreaction. However, if I can get myself, or be removed, to a peaceful and ordered space where I can sit and either think through my thoughts and feelings, or be talked through them if I’m very erratic, things can be returned to some kind of functionality** 85% of the time.

This space is something I try and plan out pretty constantly. Do I have somewhere to retreat to? If I’m in Glasgow, the good news is that I pretty much never go so mad that just being able to go home to my flat won’t help, and my flat is my ultimate sanity space – I try very hard to keep it nice and ordered so I can feel calm and safe sitting there. It isn’t always, but ideally, it would be nice if it were. If I’m not in Glasgow, I sometimes book a YHA bunk. At Empire, I’ve found that having my own tent on the field in the IC area is super helpful as I regularly can check in to my quiet calm space and reorder and tidy that until both my space and my brain are a bit tidier. I’ve also learned, through bitter experience, that a hotel room off site, that is inaccessible unless I’m traveling back with a carload of other LRPers is not adequate and can lead to bad things. Again, this also needs to be something I’ve arranged that I am not relying on anyone else for. My access to quiet space should be there even if I’m surrounded by people telling me I’m being stupid and overreacting and need to suck it up and deal. I am exceedingly bad at sucking it up and dealing. This is why I’m considered a fucking lunatic.***

4)      Lists. Oh god, lists. Lists were something I originally created when suffering badly from depression and they were really basic. Like…staggeringly basic. A list for a day might be 1. Get up. 2. Shower. 3. Brush teeth. 4. Eat. 5. Leave house for at least ten minutes. 6. TRIUMPH! Since then, I’ve discovered that there is basically no situation in which having a plan, worked out carefully in advance by sane-brain, and recorded on paper, ideally in a pretty book with stickers and check boxes that I can tick off is a bad idea.

I recently discovered bullet journals and they are literally the most amazing mental tool ever. I love making up my journal for the next week. I love designing and printing my own stickers (I can’t draw. I can design and cut out). I love making my plans and ticking things off and it means I feel in control, organized, functional and when I’m wobbly, I’ve got a nice list of things written out which I can follow and trust back up brain to guide me where batshit-brain is failing. It is great for LRP (when feeling anxious or shy, it’s always good to have a nice helpful reminded to put on costume, go on battlefield, hit orc), it’s great for work, and it’s great for me not beating myself up constantly at how fucking useless I’ve been because I HAVE A LIST AND IT IS ALL TICKED OFF AND THAT MEANS I AM AWESOME. Sorry. Caps happened. But I really like my journal. Again, a lot of my mental management is creating an external structure to support my internal mental structure. I make clean and tidy spaces in the hope that my brain will follow suite.

5)      Mantras. Oh god, the mantras. Generally, these happen in a similar way. I chew over a certain issue for a while. Sometimes days. Sometimes weeks. Sometimes longer. Then one day it comes to me – a single sentence which seems to encapsulate a particular life lesson that will guide me through whatever problem I am facing. I then write this down. And when I am feeling bad, I repeat my mantra to myself, over and over, until I believe it. Now, my mantras might not always be sane (people have told me they aren’t), but they are fucking effective at beating crazy-brain into order.

Mantras include; ‘rules help control the fun for everyone’,**** which reminds me to keep up with the meds and the lists and to keep all my coping structures in place and to never just follow my heart or some bullshit which is very high risk when my heart often wants me to put a load of flights on my credit card and follow the sunset until I land somewhere; ‘my issues are not your problem’, which reminds me to never blame other people for my mental illness. This sometimes means I beat myself up when I don’t have to, but does mean I’m less bitter; ‘you can’t take what someone doesn’t want to give’ which also means I try and avoid making demands of other people and cuts back on bitterness at feeling rejected; and ‘reasons are not the same as excuses and definitely don’t work as justifications’ which basically means that I don’t feel justified in being mad or unreasonable. Others include ‘food has no moral value’ which has been transformative in changing disordered eating patterns and ‘you can’t control how you feel. You can control how you act’, and its close relation of ‘feelings are never right or wrong. Feelings just are. Only actions have a moral value’. Oh, and my most recent one, which is about accepting long term mental illness, is ‘there is no light at the end of the tunnel. But that doesn’t mean you can’t carry a lantern’.

I am aware that my natural inclination to see the world as some kind of highly coloured passion play, but I work very hard to try and have a neutral perception on the world and see it as it is, not as it should be. This probably makes me annoying conversationalist. But it keeps me much saner.

6)      I have carefully trained my brain into never assuming anything I feel or have an emotionally response to is real. This also probably makes me a frustrating conversationalist. Every single thought, every feeling, every instinct I believe is probably a lie, until it’s been dissected, traced back to its root, analysed and pinned down.

This doesn’t always happen – I suffer from crazy-strong emotional responses at times – but I work very hard to constantly do this and any time I’m not, it probably means I’m a bit more mad than usual. Ooooh! More mantras! Passion is a lie. Logic is the answer. Never listen to your heart. Never follow your instinct. This also means I tend to get terribly uncomfortable in highly emotional debate because it’s not something that’s at all safe for me. If I let the emotions out, they tend to arrive in a shape akin to a rampaging rabid dire wolf. This is terribly bad.

Some emotions, obviously. I’m not a machine. But I’m highly suspicious of strong emotions and I don’t like emotions I can’t explain properly. They have deceived me in the past and I don’t trust them now.

This ties into something else – I analyse and dissect every thought. And I do it slowly, carefully, normally in writing, and I do it until I understand what is motivating everything. It all has to be rational as well. Logic is my friend. Emotion is the enemy. What I am feeling is no guide. What I can rationally deduce is far more helpful.

7)      This isn’t a coping strategy so much as something I’m lucky to have – my job. It’s amazing. I have flexi-time and I can work from home if the outside world is difficult. Mostly, it’s very helpful for me to have something that gets me out of the house for a regular period of time and I love that it’s creative enough that it gives my brain something to do. Boredom drives me crazy. I’ve never been so mad as when I was an admin, and I’m incredibly glad I fought off my CPN’s suggestion that I go on ESA and got out of administration. I suck at admin.

I love having a purpose, I love having something that gives me a bit of routine (but not too much – I can’t do the same thing every day) and I love that it gives me flexibility and lets me be creative and lets me feel good about what I do in the world. Actually, this doesn’t need to be a job – purpose/routine/creative outlet/positive impact on the world. That is what matters.

8)      Mental chewing gum. This is something jez pointed out to me a while ago. I go batshit crazy if my brain has nothing to focus on. Seriously. I had one day recently in which I had nothing to think about. I was restless and twitchy and grumpy by 8 pm. I hated it. I spent the evening pacing in the sitting room like some kind of caged animal.

So the next day I wrote 2000 words of random tat gaming prose and was better again. In general, I seem to be happy if I constantly have something to ponder that it outside of my routine – stories, philosophy, history – they all work. In the past, I went too far into this and tipped into crazy escapism. This was also bad and I drew back. Now I’ve accepted I need both structure and real world daily accomplishments – work and bullet journal and house take care of this – and something bigger to think about. If nothing else happens, I just write poems or drabbles until my brain feels clean again.

9)      Cooking and cleaning. This is stupid and 1950s and makes me feel like I have betrayed feminism, but god, these two things help. This is, I think, because both are slow methodical processes by which I improve my environment. Both slow me down and focus me at the same time, which are very very good things to do to my brain, and give me something nice at the end. And cooking is one of the few creative things I can do. Designing my bullet journal has a similar effect, as does gardening. Slow methodical processes with something attractive and tidy at the end. Better than Valium. Trufax.

10)   Words. Oh god. Words. I write constantly about me. My diary is a thing of horror – I dissect everything, record everything, give all the swirling chaos within a name. I name, I shape, I control. I do this talking to jez, talking to my cats, talking to the small stone dragon in my garden. Name it. Shape it. Control it. An actual audience is better, but I’ll settle for no one. Generally, no one is best if what I’m doing is working through mean, angry, emotional blame shit, because an argument doesn’t help me. Creating blame or conflict is no good, and I stick to my mantra – ‘my issues are not your problem’. But equally, leaving any emotion or crazy in a swirling vortex is dead unhelpful. Plus, as I name things, I can break them down. The screaming rage filled chaos is overwhelming. A list of 20 different issues is something I can manage, and sometimes it helps to see, written in front of me, that what is scaring me is that I have to die because the posters said so. I need to be pretty crazy until that sounds reasonable in black and white.

And sometimes the words do need to go to other people. As a part of this talking thing, I’ve developed a small number of people who I’ve trained myself to listen to as well. Jez is one. Jason is another – Jason is someone that my brain, even at its craziest, knows is wise and safe and will catch me when I fall. Put the thoughts into words. Say them out loud to someone you trust. And learn to hear their words as well. I still remember the text Jason sent me once as I sent him a stream of random thoughts. “Go find Ginnie. Sit down. Have a glass of water. Take some pills. Do you trust me?”

I did. And he got me home safe. This is probably the only area where I do rely on other people. I try not to be a burden, but no one is an island and I’ve learned over time that sometimes I do need my people to tell me when it’s time to ask for more. When I need a bigger net.

And that is me. I don’t know if any of that was useful. I know this isn’t an exhaustive list. But it is mine and it works. It keeps me steady. It’s got me this far. How about you?

*Mantra one.
**Functionality might be ‘I accept that maybe it’s not super rational to think that I am about to ascend into the sky and maybe I do need to let someone take me home so we can call the doctor’. But it’s a huge improvement on my running until my legs give way because….reasons.
***Recognised medical terminology.
****Thank you, Monica, from Friends. I think you may have actually saved my life at least once.

Date: 2017-02-03 03:47 pm (UTC)
From: [identity profile]
I don't really have a how about you? much, apart from lightbox, D3 and ionizer in the winter, but I can relate to needing a clear space.

I don't think you should beat yourself up about the cooking and cleaning thing - feminism is about choices, and this isn't you doing it because you feel it is your role and you have to. You are doing it because the process helps and the end results help.

Cooking wise, do you have many cookbooks, because one of my fun things I subscribe to is ? It's an online index of cookbook recipes listing their ingredients (you can also use it for as many online recipes as you want for free, actual cookbooks are subscription based). So, for example, if you have some pork chops, you can type pork chops into the search function and all the recipes you have with pork chops in them pop up with their location. I find it invaluable for trying new recipes and breaking out of my comfort zone. They have a huge amount of online recipes indexed (with links to the recipes themselves) so it's well worth a prod to see if anything appeals. Just thought it might appeal to the methodical list making side of the Sally :)

Date: 2017-02-03 05:07 pm (UTC)
ext_20269: (Default)
From: [identity profile]
I love recipes. I am overwhelmingly not a proper cook - I have zero ability to look at a bunch of food and say "I'll make something...spicy with a bouquet of violet" and cook. I definitely require precise instructions, which I think is a part of the whole beautiful structured ordered process.

I love measuring things out and setting timers and making lists. And goodness, yes, that website looks awesome and very helpful! Definitely good for the Sally.

Date: 2017-02-03 05:10 pm (UTC)
From: [identity profile]
You should definitely take a look at eatyourbooks, then. I just checked the online only recipe section and there's 240,000 recipes there :D

Date: 2017-02-03 04:31 pm (UTC)
From: [identity profile]
Thank you for sharing this. Some sound like they'd work for me and others don't, but this is exactly what I meant when I said I was impressed by the amount of work you put into your wellbeing.

I'm sure to you, most of this stuff is now second nature and what you do notice is when it slips or falls through. But look at this list (!): this is a lot of non-trivial things. You make a concerted effort, all the time, to manage your health and wellbeing. I think you've managed pretty amazing results, but regardless of that... you've managed an amazing amount of effort. And it's not effort that is often recognised or acknowledged, but... is very hard to maintain. So go you.

Date: 2017-02-03 05:20 pm (UTC)
ext_20269: (misc - red ballet shoes)
From: [identity profile]
Yeah, I guess this is a fairly long list, and it's all stuff I didn't start out doing, and worked out over time as a good way of managing stuff. I didn't do it all at once though.

1 - work in progress, slowly coming together over the last five years. And I think it always will be because I hate taking pills.

2 - work in progress, although I think I started doing that in about 2004 when I was having a particularly bad period of panic attacks/sobbing/self harming/more panic attacks on a daily basis. Looking back on it, it was probably the longest and most sustained depressive episode I've had. God knows how Jez survived it. I started trying to break down my issues and working out what had really caused something, just to get a handle on it. Totally self preservation. Insisting all those coping mechanisms be not reliant on others slowly got added in over time after several incidents of me getting irrationally and unfairly angry with people for not helping me. No idea when I started but I remember the original variation of that mantra - "you can't take what someone doesn't want to give" hitting me with remarkable force when I was living in Edinburgh, around 2003 ish? Just before I left (when I was also v crazy).

3 - this has only emerged as being as totally essential as it is since I moved to Glasgow and suddenly had the space to do that. And it was a revelation. My sitting room in Ripon Drive was the first totally ordered space I'd had since I left home and HOLY FUCK it made a difference. So, that's from the last two years.

4 - I can't remember when I started doing that - I think that's in the last 5 years too. I started doing them when I was just out of hospital and working with my lovely CPN in London, Sam, who I miss daily.

5 - I've done those for years. They have kept me back from both suicide and homicide at times.

6 - this is a work in progress. I am sometimes better at it than at other times. I've worked very hard to get this right in the last 5 years or so as I had some massive slips in the few years before them of trying to vilify people or justify my own behaviour based on very shonky emotional responses. I am still not all the way there, but I'm working on it.

7 - In the last 18 months I've realized how important this is. A job that works for me makes me remarkably sane. Sadly, a job that doesn't makes me remarkably crazy. I have a whole frustrated rant somewhere about the current benefits system which says you can either not work at all, or work full time, doing any job. And I don't think it works that way.

8 - I've known I do this for years. It was literally this week that jez pointed out how core it is to my sanity and how I reliably develop weird caged animal responses if I don't have it.

9 - This is all stuff I've realized in the last year. Never did it before then.

10 - I've done this for years and years and years. All my life. I think it's the reason I got as far as I did without being sectioned - I use words as a control mechanism constantly - how to understand, how to interpret, how to make real. It is the basic form by which I give reality structure and turn my dragons into newts.

Date: 2017-02-07 09:29 am (UTC)
From: [identity profile]
I think the words part is actually a relatively uncommon, but incredibly good strategy. Uncommon, rather than unusual, as I see a lot of advice to do with writing stuff down and putting it out of your head and so on...

I think it's very easy to think you know exactly what you mean in your head, but not finding the actual words until you put them out (that might be me, as I find a lot of other people think directly in words?) or, more importantly, being able to ignore just how unreasonable some of The Crazy is while it's still in your head.

I should write more, even if it's never saved anywhere; it's a good method to slow down and think and process. Thank you for reminding me.

Date: 2017-02-07 09:51 am (UTC)
ext_20269: (Default)
From: [identity profile]
The words strategy is staggeringly helpful for me, most of all because it really helps me pin down and understand what is really upsetting me. And, in general, if I hunt through the hugely irrational emotions (stage one of the words strategy normally involves me realizing that I am overreacting) I normally find there is a root cause that is real and can be addressed. I mean, sometimes that root cause might be something I don’t have a totally objectively justified reason to be feeling wobbly about, but at least I can recognise it.

And I also feel better for getting stuff out and writing it down. One thing I used to do (when I had a LOT of IoD characters and did a LOT of scening) was to randomly project my emotions onto a character and write about it. So, I might write a werewolf story about ‘sorrow and loss’ in which I got all the feelings out but through a fictional channel. Weirdly, that had about an 80% success rate in clearing up mental junk. So sometimes I think the words strategy is helpful just in that it gets feelings outside of me and onto paper.

That definitely may be me being odd though.

Date: 2017-02-03 05:53 pm (UTC)
ext_20269: (Nonsense - hedgehog courage)
From: [identity profile]
There's also some other stuff I do. I realized I didn't add in teddy bears, bubble bath or pacing myself relentlessly. But that's important too.

Date: 2017-02-04 01:03 am (UTC)
From: [identity profile]
I have been rereading this and I think it's a great list to have for anyone. I will think on.

Date: 2017-02-04 01:09 pm (UTC)
From: [personal profile] eniel
Thank you for sharing. Many of these definitely ring a bell with me.
Lost my work to-do list that had all my tasks laid out for the week last Tuesday and spent the whole day in a mild state of panic thinking there might be something I'd forgotten to do... didn't really feel better until I gave up trying to find it and made a new one.
Again, what an impressive amount of work you have done to figure all this out!


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