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.
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September 2017

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