Wednesday 29 September 2021

Return to Down: How My Baseline Mood Has Slipped from Positive to Low

I’ve felt below par mentally for a while now. It’s possible I’ve been depressed, although I’m wary of self-diagnosis and haven’t sought a clinical opinion. I can trace some of it back several years but I’ve only lately felt up to talking about it publically. It’s not that I’ve ignored my mental health altogether. I’m aware of many of my triggers; the situations and events that tend to pull the rug out from under me. I captured the main ones in my Wellness Recovery Action Plan (WRAP) back in 2019, and review it periodically. My triggers include:

  • Changes in relationships (which I tend to perceive as lessening, loss, or abandonment)
  • Uncertainty or lack of clarity in communications
  • Getting overwhelmed by competing demands for my time and attention

My triggered responses include feeling anxious and panicky, a strong sense of loss or abandonment, and becoming either pushy or clingy. My WRAP includes recovery strategies which help me return to my baseline, such as talking things over with Fran and other trusted friends, pulling back to assess what’s happening, and focusing on my writing. These strategies have served me well, until now.

In last week’s blog post, I mentioned feeling flat, low, and empty, but being unable to identify any of my usual triggers. My key friendships and relationships have been solid for a while now, communications are clear and unambiguous, and although there’s been a lot going on, I’ve not felt consciously overstretched. Nevertheless, my mood has often dropped suddenly — at times precipitously — with little or no warning. Something is different but it’s taken me a while to figure out what it might be.

I’ve always believed my emotional and mental health baseline to be essentially positive and healthy. Things might happen at times to upset my equilibrium, but after a shorter or longer period I return to my place of stability and wholeness. Lately, though, this model has been turned on its head. Instead of events and situations disturbing me from an essentially healthy baseline, it feels as though my baseline itself has shifted downwards. Positive events and situations such as meeting up with a friend, or feedback on one of my blog posts — essentially any of the things I was grateful for last week — can lift me up, lighten my mood, or provide an alternative focus for a while. But, once the distraction has passed, I’m pulled back to this low mood baseline. I’m reminded of the rubber band effect Fran uses to describe the “rebound crash of pain and fatigue” she gets with her fibromyalgia if she exercises or exerts herself too much.

No model can be completely accurate, but the best can help us — and others — appreciate what’s happening in our lives. Fran and I have used a variety of models to explore how illness plays out in her life. We describe several in our book, including this layers model:

In terms of responsibility, Fran finds it helpful to acknowledge there is an underlying layer of biological illness. It may respond to clinical intervention, including medication, but she is unable to influence it directly. Above this, there is another layer which Fran can affect, through meditation and mindfulness, exercise, and making healthy choices about her food, drink, and sleeping regimes. Thinking about illness in this way eases the burden of guilt, and allows her to focus her energy where it can be most effective.

I only began explicitly tracking my mood in February 2020, but three times a day for six months I rated my mood on a six-point scale that ran from zero (“struggling”) through “low,” “flat,” “OK,” “baseline/positive,” up to a maximum value of five (“really good”). My healthy-baseline-with-occasional-low-periods model remained valid throughout. Outside events and changes (either real or imagined) in my relationships evoked sudden and occasionally dramatic drops in mood, but I returned to my positive baseline without much trouble or delay. As I noted at the time, “My mood is closely tied in with what’s happening in my life, especially in my key relationships. This isn’t news to me (or my close friends) but the tracker has brought it into clearer focus.”

I haven’t tracked my mood since last August but on that same scale I’d say my baseline has dropped from “positive” to somewhere between “flat” and “low.” That’s a significant shift but how and when did it occur? I found it hard adjusting to working from home and not meeting up with friends during the first covid lockdown, but my baseline held up, as my mood tracker attests. I can think of events towards the end of 2020 that upset my equilibrium and might be significant, but the first clear sign of change is an article I wrote in March this year. In What If I Never Do All the Things I Used to Do? it’s clear I was struggling to remain positive.

At some point, though, it dawned on me that things will never return to how they used to be. The impact of covid, of lockdown, of all the changes we lived through last year and are still living through, is simply too great for us to pick up where we left off. Vaccinations will allow us to move forward but right now, as England begins gradually to open up again, I can only see that many things I valued (and some I took for granted) have already gone beyond any hope of retrieval. Others may resume, but they won’t be the same. I’m not the same. We aren’t the same. How could we be, with all we have gone through?

Contrast that with the robust optimism of “Remember When?” — Building Shared Experience in Unprecedented Times, written one year earlier, a month or so into the pandemic.

It occurred to me that we’re doing more than checking to see people are okay. We’re supporting each other, yes. But even more than that, we’re sharing our experiences in what truly are unprecedented times. [...] There will be tears and pain when we look back on the pandemic of 2020. But there will also be joy and laughter, and the comfort that comes from surviving dark times in good company.

I may revisit these blog posts now things have largely opened up again. I’ve been able to meet up with local friends. I’ve reclaimed a couple of things I feared lost forever and found some new ones. Nevertheless, this lower baseline appears here for good — or bad. However I got here, I need to figure out what that means. In another recent post I shared a little of the changes I’ve noticed in my daily diary:

Looking through my journal, there are things I’m used to hearing from others but have rarely felt — and even more rarely expressed. Have I just been feeling low or is it something more serious? I tend to assume my experiences, dark moods included, scarcely register compared with what others go through. But what if I’ve reached somewhere they would recognise. How would I know?

Feeling low is scarcely unique or unexpected given all we’ve lived through these past eighteen months. It’s unusual and unexpected for me, though. I’ve become much less positive, optimistic, and hopeful than I can remember being in a very long time. In unguarded moments, I’m overwhelmed by a deep, aching emptiness. I can shift my mood, but sooner or later the rubber band takes hold and I find myself back on my new baseline. Is this (to use a term I’ve come to loathe) my “new normal”?

I’m unsure what to do about it. Maybe there’s nothing to be done about it, other than to keep moving and see it through to the other side. Being open about how I’m feeling is part of that. I was chatting with my friend and fellow mental health blogger Aimee Wilson last week:

Hi Marty. What are you up to?

Doing a bit of blogging. The one about my mood shifts.

Are you finding it OK to write about that kind of thing?

It’s not flowing all that well at the moment, but yeah. It feels kinda important and real, yunno?

That’s so good!

Thanks. I’ve learned from the best!

A few days later, we had the opportunity to talk face-to-face. I shared my insight about my baseline shifting downwards, and how I was tryng to figure out what it means. We discussed how people often set their needs aside — sometimes for years — in order to support others who may be in more immediate need. Eventually, though, things may catch up with them to the extent they can no longer be ignored. That was very much the case with my mother. She supported my father for decades as he became increasingly disabled with arthritis. After he died and I left home for university, she devoted herself to supporting other people. Her mental health deteriorated to the point where she was barely able to cope. She spent her final years depressed, anxious, and wracked with guilt for not having done more. At her funeral, the minister praised her as a living saint, but to me, that degree of self-neglect is far from laudable.

Something that feels very relevant is the convenient but problematic labelling of people as either “ill ones” or “well ones” (as Fran and I express it in our book). The distinction has value but it can lead people like me who are relatively well and stable to ignore or downplay signs we’re not doing so well. Aimee and I agreed that health, especially mental health, is not a competition. No one should be shamed or ignored because they imagine they’re struggling less — or more — than someone else.

Things change. Situations and relationships change. Our health changes, sometimes for the better, sometimes not. We all need to pay attention, me included.

This is me paying attention.

 

Photo by Adrian Dascal on Unsplash

 

2 comments:

  1. Sorry You've been down, but looks like you might be learning from your mother to look after yourself before you can care for others. Don't be a saint.

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    1. Thank you, Anne. You're right that I don't intend to fall into that particular trap. Being a Saint wouldn't suit me anyway x

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