Getting Well and Staying Well

This article is excerpted from chapter 3, “The Way to Wellness: Treatments, Therapies, and Vigilance,” of our book High Tide, Low Tide: The Caring Friend’s Guide to Bipolar Disorder.

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Getting Well and Staying Well

In the last chapter [The Illness Experience: Understanding Your Friend’s Diagnosis and Symptoms] we explored the symptoms Fran lives with day-to-day. Let’s turn now to how she limits their impact, so as to live as fully and richly as possible. We discuss only medications, therapies, and other treatments Fran has used personally. These may not be directly relevant to your friend’s situation. As Fran expresses it, “What works for me may not work for you, and vice versa. We need to find our own ways and make peace with them.”

It is also important to note that no strategy works forever. What we report as having worked for Fran in the past may not do so in the future. In the realm of chronic illness, wellness is a dynamic experience. We hope, nevertheless, to convey two important messages. The first is that there is no magic fix. Complex conditions such as bipolar disorder are likely to require multidisciplinary approaches including medication, therapies, and behavioural strategies. The second message is that it takes formidable commitment to stay as well as possible. It is not unreasonable to hope for dramatic improvements, but they can be a long time arriving, and may not last as long as you and your friend would hope. If so, it is not your friend’s fault — nor is it yours.

The Nature of Wellness

We all want the best for the people we care about. If they are ill or hurting, we want them to get better. But for someone with chronic illness “getting better” is not like waiting for a broken arm to mend or an infection to clear. Wellness can never be taken for granted. It is neither a prize to be won nor a place of safety to be reached. It is more like a skill that can be developed, practiced, and refined. Medication has a role to play, but there is a lot more to it than remembering to take your tablets.

For me the basics of wellness are nutrition, exercise, sleep, and hygiene. Those are non-negotiable. I start wherever I am and make the tiniest of shifts and changes, whatever I can handle at the time. It’s as if your body/mind is a spaceship and you are creating the owner’s manual. You are the only one who gets to make those choices. You can then share this manual with others who can support you in your process.

Acceptance is critical. It was only when I came to utterly accept my illnesses and myself, stopped desperately looking for fixes, and realized that there was nothing outside myself that would save me that my life began. I started being truly responsible and caring for myself.

There have been many things that have helped me and many things that have hurt me. I have also significantly hurt myself by my own thinking and actions. I learned that I could change that. I may not be able to be cured but I can stop making things worse. That was a revelation. I started being responsible for whatever I could, instead of blaming everything and everyone else for my problems: the doctor, the meds, friends, other people. I started owning my life.

Clinical Compliance

Also called adherence, compliance describes how closely a patient follows (is compliant with) medical advice. It can be tempting to stop taking medication if it causes unpleasant side effects, if it seems not to be working, or once symptoms have eased. It often takes time, however, for drugs to take effect, and it may be necessary to try several different treatments, individually or in combination, until a balance is found between the positive benefits and unwanted side effects.

It is rare for Fran to miss a dose, and she consults with her doctor before stopping a course of medication or starting something new. When traveling, or if her routine is otherwise likely to be disturbed, she asks me to remind her to take her tablets on time. There is also a social aspect to compliance. People sometimes see unstable behaviour and incorrectly assume the person has stopped doing all he or she can to stay as well as possible. This happened to Fran and it hurt her deeply.

[Many people] were mad at me for apparently going off my meds during what was the most excruciating manic experience I have ever had. I can understand how people might think that, especially if they do not have experience of friends or family with mental illness, but it simply was not true. I have been on many different medications over the years, and have always been completely compliant in taking them.

The truth is that no meds are perfect, and what I was taking simply stopped working for me. I saw my psychiatrist on a weekly basis, and kept all my other appointments. When my medication was changed by my psychiatrist my mania came back under control, though it was very difficult dealing with the transition and side effects, and the deep suicidal depression which came afterwards.

Bear this in mind if you are concerned that your friend might have stopped taking their medication, or accidentally missed a dose or two. There is a big difference between gently asking what is going on, and accusing your friend of careless or unhealthy behaviour.

 

Photo by Allef Vinicius on Unsplash.

 

Lessons of the Night

By Fran Houston

Sometimes I wake up. Sometimes not. I hold onto the bed for dear life. I am familiar with the night and its darkness. As a child I lived in the basement of our house as a mole does in his tunnel and could navigate through the narrow path of jagged, stacked boxes to the bathroom in the dark. The lights didn’t work.

Wrapped in my blanket of night, I am safe and warm. In the night are dreams. Dreams of all the things that can’t be done in my body because of its restrictions of fatigue and pain. I indulge my soul’s longing to fly.

The day hurts my eyes with its stinging brightness. Music hurts my ears with its loudness and overstimulation. I like the quiet of night.

I have chronic fatigue syndrome, fibromyalgia, and bipolar disorder. They operate as independent sine waves. At any time, I can be exhausted and manic, energized and depressed. Every combination imaginable. The cycles can last for days or months or even years. It’s an odd assortment.

I had a mate. I had a family. I had a home. I had a career. I had a dog. I lost them all.

I made $14,000 in the last week I worked in the real world as an electrical engineer. Now I barely make that in a year. Fifteen years ago, I paid tens of thousands of dollars to get my health back, conventionally and alternatively. It took ten years to get an accurate diagnosis. Treating bipolar with antidepressants makes it much worse. So not fun to have cfs and fibro creep in alongside.

I finally went to the backwoods of Maine for a year and lived in a camp on 189 acres with no running water and no electricity — an attempt to find my baseline, fight my demons and find the night, or die. No TV, no radio, no books, no writing, no nothing. Just me and myself, grapes and garlic. I danced naked in the woods in the pouring rain. I shoveled snow thirty feet out to the outhouse to go to the bathroom. I made snow angels under the full moon. I watched frost form on the windows. I gazed for hours at the cherry wallpaper. I slept twenty hours a day. I dropped each thought as though dropping a hot coal. I’d think the same thought again; drop the thought again, over and over. I would not get up until I felt the internal impulse to do so. I fasted. I had a sauna each week — the only excursion besides getting water from a spring. And successfully navigated men who were intrigued and unsavory. I reached the edge of madness. I waited for the Jesus experience. There is no god; there is just life that flows. There is no hope. That was the beginning. Stop the search. For god. For healing. Just stop. The maple tree doesn’t want to be an oak. They are what they are.

I moved to an island off the coast of Maine in September 2003. My dad died that Halloween night — the night when the veil between the world of the real and the unreal is thinnest. There was an aurora borealis that evening. Beauty without effort.

I lost my mind. Consumed with thoughts of jumping off the boat, a frustrated friend asked, “Why don’t you?” I panicked.

I found the psychiatrist I still see now. He doesn’t see anyone anymore, but the deal was that I agreed to be in a fishbowl where he trained six to eight other psychiatrists for twelve sessions, and then I would have him for life. He is very conservative with meds, which I am very grateful for, although at times it’s enraged me. I think that psychiatrists nowadays are too pill pushy. Meds take a long time before you can see any results. One has to courageously wade through a myriad of side effects. He also is very relationship-oriented, which few are. He is respectful of me as a human being not just as a patient. Also, making an eye-to-eye commitment to him to stay alive has been a critical component of the process.

I began intensive group therapies. I got pissed off a lot. It was a full time job. I was exhausted. I was depressed. Having to do all this work. Needing to do all this work. No hope of getting better. Homework. It was worse than Engineering school. Cognitive Behavior Therapy made sense though. Event. Feelings. Thoughts behind feelings. Change the thoughts. Huh. Seeing others who’d been stuck in their ruts changing. Me changing. Huh. Not so depressed. My mind actually thinking thoughts other than depressed ones. How refreshing.

Chronic fatigue syndrome can mean days or months bedridden. Or can be as simple as feeling like there are cotton balls behind my eyes and mud running in my veins. Pain is always present. I take Advil when it is too much, or something else. I see an osteopath, acupuncturist, and chiropractor regularly. Once when I was at dinner with a friend I fell asleep. They ushered me out of there swiftly. I’ve been propped up in lazy boys in the corner with a blanket at parties just to be able to attend. Then again friends have broken up with me because of my proclivity to say no, or act strange. As a fellow cfs-er puts it, “I feel minimally crappy today.”

Bipolar I is like mowing the lawn in the winter naked. I have bipolar II. An example of my mania is when I was out in front of my home on the phone talking wicked fast with a depressive friend, and I was frantically picking the heads off dandelions while every square inch of countertop in my home was littered with furiously ink-covered yellow stickies full of ideas and things to do and be and dreams. I am like a pit bull with a bone. Another example is when I found out about the United Nations International Day of Persons with Disabilities on December 3. I found out that VSA (Very Special Arts) out of Washington had a video that would be shown in seventeen countries internationally. My mania launched me into a full-blown attempt to notify media and government outlets seeking coverage for this event. I sent cryptic, confusing e-mails and was very agitated. I wasn’t very successful, and thought that those who I contacted thought I was a nutcase. I felt like a mouse when a cat is playing with it and then the mouse just lies there stunned.

Depression was my best friend, the one I was most comfortable with. It’s been a lifelong companion. A favorite blankie. The one I return to for wisdom. Deep and dark. I remember the pain of trying to wash a fork amongst all the dirty dishes in my sink, wrapping myself in a blanket, wearing clothes that hadn’t been washed in a month, then opening a can of tuna and sitting on the cold floor to eat it. I told a depressed, suicidal friend once that it took more courage to make a cup of tea than to kill yourself. I still do have a stash of pills because I do feel that people should have that right, especially when you are old and everyone else is making decisions for you.

The problem/blessing with my illnesses is that they are unseen by the naked eye. “But you look fine,” is the response, as if arguing with me would help. I was going to write my behind-the-scenes story in the Island Times. I talked with a friend about it — a friend who I had “iguana-sat” for during a time of deep depression, where basically the “iguana” saved my life because I had to feed it every day and felt responsible for it, and was therefore not free to commit suicide. The friend was scared of being exposed on the island and advised me to not tell my story publicly. I didn’t. That is the kind of stigma that exists with disability.

I got to go to Hawaii because of a cat. They have quarantine rules and a friend moved there, and was delayed in bringing her cat and asked if I could escort him and stay for six weeks. I didn’t blink twice before saying yes. It was beyond my wildest expectations. Some friends gave me mad money and the deal was that I couldn’t do anything responsible with it, so when I was in Kauai I went for a helicopter ride, in the front seat, right next to the pilot, and you could look straight down. I wanted him to teach me to fly. I was so jazzed. Oh, the cliffs, the valleys, the ocean, the waterfalls, the rainbows. It was magnificent. It was absolutely the most amazing experience in my life. Even better than in my dreams.

The librarian on the island asked me to sit with an elder. So I started sitting with older islanders, and it was wonderful. They told me stories. I lived on the front of the island by the ferry boat slip, a great view. I bought a camera and took pictures of the sunsets.

I was frustrated. I wanted to somehow capture the elders’ stories and share them. I went to an exhibit of black and white photographs and storyboards. My heart lit up with a flame so intense. I had never experienced that before. I knew what to do. I spoke with our little art gallery on the island about doing an exhibit. I spoke with the Island Times about doing a column to advertise for the exhibit. At the June exhibit everyone asked, “Where’s the book?” So that began another journey. Mind you, I could only work a maximum of three hours a day. And I would have bouts of depression throughout. And bouts of freaked-out-ed-ness. I leaned on my friends and the community to help me. I busily interviewed and photographed islanders for another two years. Another gallery on the mainland offered to host the book launch/exhibit. In June of 2010 the book launched. By August it sold out. It’s now in its second printing. I never started out thinking I would write a book. If someone had told me that, I never would’ve started. I would have been too scared. Even as I write this today on Christmas Eve 2010, I have friends who are coming to help me clean my little 18 x 18 home next week because I cannot manage it on my own.

This project was such a community effort. This island has given me so much. When I first got here I was amazed at its kindness towards me. I was broken and it loved me. So I wanted to give back by doing this project. I was surprised to find that again I was the receiver. As I sat and listened to the stories of my “lovies” as I called them, they taught me. Some of them have limited lives, pain, memory loss, reliance on others for care. I learned how to live my life fuller. I learned grace, courage, and how to have a twinkle in my eye. My chronic fatigue syndrome and depression limit me, but I can choose to live as fully as I want within those windows and be thankful. One thing we all do is get old. We can be wise to learn how to live our lives now.

“What’s your next project?” I hated that question more than anything. I hadn’t been able to do anything for ten years and could hardly stand up, let alone conceive of doing anything else for the rest of my life. Nobody really knew what toll this had taken on me, but I present well. My pat answer became, “I’m going to take a lot of naps,” which I did until I went into a major depression for the beautiful month of August. I don’t have seasonal affective disorder. I can be perfectly miserable in gorgeous weather and happy as a clam in the bitter cold or damp fog or pouring rain. That’s clinical depression.

“How are you?” Another hated and seemingly innocuous question. The simple answer is F–I–N–E. F**ked up, insecure, neurotic, emotional. Most friends really don’t want the long answer. This way I can simply smile and be honest gracefully.

I still have chronic fatigue syndrome. I still have fibromyalgia. I still have bipolar. I manage them. They don’t manage me. They are a part of the package instead of who I am. I’ve learned to live alongside them, as esteemed companions, my teachers. Step by step, thought by thought, moment by moment. A little flame, follow it. Lessons of the night. I have this very simple view of life now. The good and bad come and go. Don’t hold onto anything. I love the moment. Every bit of it. That’s all I have. Heart wide open. It doesn’t matter if someone kicks you; just point yourself in the direction you want to go. As far as god, I don’t know. How can there not be?

The edges of the night are the best. Sunset, when the light slips below the horizon. That one moment taking the light over the rim of the earth, and rest comes. After which, the colors swell and dreams begin.

Fran Houston
Peaks Island, Maine
December 2010

 

Postscript

This was the first piece I ever wrote, and chronicles some of my journey of illness and how my creative endeavor helped me emerge from the hole, to know and experience a bigger life of possibility and change. Months after it was written I experienced my most delirious mania, followed by the most hellacious depression ever. Thankfully I had a hand to hold.

 

Photo by Tyler Clemmensen at Unsplash.

 

Medicine, Morality, Personal Growth: Three Models of Illness and Wellness

If we want to support our friends and loved ones, it is important to understand what we mean when we talk about illness and wellness. It would be easier if everyone approached these topics in the same way, but this is not always the case. Our attitudes towards illness and wellness are heavily influenced by our lived experience, as well as broader societal values and beliefs. In this article I want to discuss three models of illness and wellness which Fran and I have encountered at different times in our lives.

The Medical Model

This is the standard Western medical, scientific approach, and is how I was trained to think of illness and its treatment when I studied pharmacy at university. According to this model, the body is a complex machine and illness occurs when components fail or malfunction. The patient is the owner or inhabitant of a machine which has gone wrong and needs fixing. Diagnosis and treatment are the responsibility of people trained in the medical specialties and the patient’s main role is to follow their advice and instruction. Treatments, including medication and surgery, aim to fix what has gone wrong, or where that is not possible to reduce the impact of symptoms on the life of the patient.

This approach can hugely benefit people living with illness, including mental illness. I have seen how dramatically lithium moderated Fran’s suicidal thinking, reducing it to levels she was able to deal with. I have also witnessed the stabilising effects of medication when she was in mania. Of course, outcomes are not always as precisely targeted as this, nor as positive. Fran has been prescribed a wide range of drugs over the years. Not all were effective and most brought unwanted side effects. Side effects are an unwelcome aspect of Western medical practice, and something many people who have undergone treatment for mental illness will be familiar with. This often leads to a number of different medications being prescribed, either to limit the dosage, and thus the side effects, of individual drugs, or to offset the side effects of one with the positive effects of another.

There is little or no moral or spiritual dimension to this approach, although science and the medical professions sometimes appear so elevated and “obviously right” that anyone doubting their relevance or wanting to try different approaches runs the risk of appearing ungrateful at best, misguided or dangerous at worst.

It is tempting to hand responsibility for the care and wellbeing of our loved ones to those who have been trained to know best. I remember feeling relieved when my mother was severely ill with depression and anxiety and was admitted to hospital. At the time she was probably incapable of making a recovery on her own, and the care she received in hospital was appropriate and supportive. Nevertheless, blind trust in professional “experts” can be disempowering, if it removes the patient’s responsibility, and that of their loved ones, to take a role in their path towards wellness.

The Morality Model

It is my personal view that there is no moral component to illness. Illness is not some evil thing to be overcome by the forces of good. Many “good” people get ill, as do many “bad” people. Guilt and blame can be debilitating emotions and may well interfere with how someone approaches their wellbeing and recovery but as far as I can tell, some “good” people and some “bad” people recover from their illnesses, and some do not. Nevertheless, a number of more or less related views place illness and disease within a moral or religious context. For someone who is religious, this might be helpful and constructive. Their belief in a higher power may help them feel supported, or that there is some deeper meaning to their experience of illness.

There is a line, however, beyond which the link between illness, suffering and belief can take on a darker, even sinister hue. Some maintain that a person becomes ill, or remains ill, because they have been bad in some way, or lack the moral strength to overcome their conditions. The patient may undergo conventional medical treatment but there is an assumption, whether implicitly or explicitly expressed, that they also need to atone or repent if they are to recover fully.

This kind of thinking can lead someone into agonising guilt and despair, not only for whatever wrong they imagine they have committed in the past, but for not atoning, repenting or believing sufficiently in order to be healed. A blessing from a priest or spiritual authority may be comforting to those who believe, but at its most extreme, this kind of thinking can countenance exorcisms on people whose mental health conditions would be better managed with less religion, more compassion, and an appropriate regime of psychiatric care.

Sometimes it is not the patient but the illness or disease which is described in moral terms, especially aggressive, debilitating or potentially fatal conditions. Cancer in particular is frequently portrayed as an evil invading force, which must be hated, resisted, fought, and overcome. The person with cancer is generally held to be a hero, bravely battling the enemy against overwhelming odds.

The situation for those attempting to deal with mental illness is likely to be very different. There is generally a poor distinction between bad behaviour and mental illness. On one hand, those affected by mental ill health tend to be treated with less generosity and greater suspicion than those with other conditions, and their symptoms may be poorly differentiated from immoral or criminal behaviour. On the other hand, those who perpetrate extreme, violent, or malevolent crimes are routinely and habitually assumed to be mentally aberrant, irrespective of evidence or clinical diagnosis. The extreme nature of their crimes places them so far outside the norm that society requires them to be mentally ill so as to place them at a safe distance from the well ones.

The Personal Growth Model

In the third of our models, illness is seen as the expression of issues and lessons that the person needs to become aware of, understand, and work through. I do not agree that all illnesses can be viewed usefully in this way: the approach seeks to attribute meaning and significance to all bodily symptoms, and excludes the possibility that some conditions are the simple result of malfunction in bodily processes. That said, I agree there can be much more to illness, including mental illness, than the symptoms which present themselves on the surface. Effective treatment is likely to involve a broad approach which may include, but is certainly not restricted to, conventional medical or psychiatric intervention.

In the time I have known her, Fran has followed a number of therapeutic approaches to wellness, building a composite approach which works for her and encompasses a number of different techniques. These include medication, but at different times have included hypnotherapy, acupuncture, osteopathy, Emotional Freedom Technique (EFT), meditation, and mindfulness. She has also undertaken to explore the relationship between aspects of her illnesses and long standing issues relating to her childhood, body image, and sense of self-worth.

It seems to me that this kind of approach has merit, providing the person is open to deep and honest self-inquiry, and is able to accept responsibility for certain aspects of their illness without translating that into debilitating guilt, blame and despair.

Bringing It Together

No matter what views you and your friend or loved one hold towards illness and wellness, it is vital to respect the differences in emphasis and approach. No single model is wholly right or totally wrong. Discussing where you agree and disagree will bring you closer together and can lead to a greater understanding of who you are and how you can work best together. As Fran has expressed it:

One can either be actively supportive and compassionate of an ill one.. or judgmental and condemning.. Why I am ill.. I do not know.. I do take responsibility for being as well as I can be.. I have accepted there is no cure and finally that gives me peace and grace.. instead of when I was desperately seeking healing, which created enormous anxiety.. and fear about what people think about me.. those who would judge me judge themselves.. and i pray they don’t have to get ill to learn the lessons..

I have shared my thoughts on three models of illness and wellness, but there will be many others. How do you think about illness and wellness? Do you have the same or similar thoughts about it as your friends and loved ones? Have you ever discussed these topics with them? We’d love to hear your thoughts, either in the comments below or through our contact page.

 

This article is adapted from material original written for our book High Tide Low Tide: The Caring Friend’s Guide to Bipolar Disorder but not included in the final editions.

Photos by National Cancer Institute, Jaclyn Moy, and Jared Rice at Unsplash.

 

How to Educate Yourself about Your Friend's Mental Health Condition

It’s easier to be there for someone if you understand what they’re going through. But how can you understand if you’ve never been there yourself? That’s the situation I found myself in when I met my best friend Fran for the first time in 2011.

Fran lives with three chronic health conditions I’d never experienced and knew nothing about: bipolar disorder, chronic fatigue syndrome (CFS/ME), and fibromyalgia. Being her friend didn’t mean I had to become an expert in any of these but I wanted to learn as much as I could, so I could be there for her as effectively as possible.

I’m sharing my education journey in the hope it might help someone in a similar position. I’ll focus on bipolar disorder but the principles apply no matter what mental or physical health condition your friend or loved one lives with. It’s also relevant to other lived experience including abuse, bereavement, discrimination, self-harm, stigma, suicidality, or trauma.

Whatever your friend’s situation, approach educating yourself about it as a privileged insight into something you may never fully understand.

Why Bother?

You might wonder why you’d want to take the time and trouble to learn about your friend’s health condition. What’s in it for you? Fran never asked or expected me to educate myself about her situation, but our friendship has benefited enormously in many ways. Yours can too.

• You’ll be more aware of what your friend is going through.
• You’ll be more aware of, and better understand, potential treatment options.
• You’ll be better placed to support your friend in ways that are helpful to them.
• You’ll find it easier to hold an open and non-judgemental space for your friend to talk about what’s going on for them.

Most important of all, you will demonstrate your commitment to your friendship. Your friend is far more than their illness and symptoms, but by taking time to learn what you can, you’re acknowledging the impact they have in your friend’s life.

Educating yourself isn’t about proving what a great person you are, diagnosing your friend or helping them self-diagnose, showing you know more than they do, telling them what to do, or intervening in their life or treatment. The only exception to that is if you feel they are in urgent need of help or are at immediate risk.

You’re not doing it solely for your friend, however. In Why Do You Do It? I described some of the things I’ve learned about myself and how much I’ve gained personally.

I am a better person for knowing Fran. I have a greater understanding of my strengths, values, weaknesses, and vulnerabilities than ever before. I have learned more about mental and invisible illness, suicidal thinking, stigma, determination, courage, and responsibility since we became friends than in the fifty years before we met. [...] I have greatly expanded my circle of friends, met people who feel safe sharing their stories in response to mine, and learned how it feels to offer my skills and experience in the service of others. I have grown — and continue to grow — as a friend and as a man.

I’ve shared a few further insights in a post titled Three Things I Wish People Knew about Loving Someone with Mental Illness.

How Much Do I Need to Know?

No one is suggesting you enrol with your local school of medicine or train as a counsellor or therapist. Fran doesn’t need me to be an expert. She is the expert in how her illnesses affect her, and has professionals to fulfil those specialist roles. It took a while for me to understand where I fit into that team, what I could usefully learn, and how my unique perspective could benefit her most. As I describe in our book:

At first, I imagined I could discover all I needed to know by talking with Fran and spending time with her. I learned a great deal, but after a while I realised I needed additional sources of information. No book, website, or training course can tell me how illness affects Fran personally, but she does not know everything about mental illness and cannot provide a broader, impartial perspective. I seek to educate myself by talking to people with lived experience, by reading books and online material, by taking relevant courses and training, and by participating in the wider mental health community.

Let’s take a look at my journey in a little more detail.

Start With What You Know Already

It wasn’t just that Fran lived with three illnesses I didn’t understand. More fundamentally, she lived with illness, and I needed to get my head around what that meant before I could move on to the details. It helped that we were able to discuss what wellness and illness meant to each of us, and the very different life experiences that had brought us to those individual understandings. Acknowledging the differences provided a solid foundation for the next stages in my education journey. You can read my experience of illness here.

Talk to People With Lived Experience

There’s no better way to understand what it means to live with illness than by talking with people who actually do. Fran and other friends have encouraged me to learn about their health conditions. It’s important to remember, however, that it’s not their responsibility to educate me. In particular, there are times when they have far too much going on in their lives to help me understand. I recall one friend who found it exhausting having to explain things to me all the time, especially when she was struggling. At such times, she needed friends who understood what she was dealing with because they’d been there themselves.

I learn best by exploring what Fran or other friends are experiencing in the moment, rather than trying to understand everything all at once or treating them like a reference textbook. Relentless questioning is unnecessary and unkind, but asking appropriate questions can help each of you explore what’s going on. My friend and fellow mental health blogger Aimee Wilson expressed this beautifully in an open letter to me on her blog:

I love that you ask me questions when I’m struggling because it’s much more helpful than you just sitting there and nodding along, pretending to understand.

I’ve explored what I mean by appropriate questions in a previous article. Bear in mind there may be things your friend is unwilling or unable to talk about, either at that particular time or at all. If so, respect your friend’s boundaries and don’t push for more than they’re prepared to share with you.

Asking questions implies listening to the answers. Listening is an important skill in itself and harder than it seems. Treat it as part of your education journey. As well as learning about your friend’s health condition, you’re learning to communicate effectively and compassionately. One of the most valuable lessons I learned is that there are different types of caring conversation, depending on a person’s needs at the time.

It’s not all about symptoms and treatments. There are some things you can only learn by talking with someone who has lived experience, such as the determination it takes to keep moving forward despite crippling anxiety, depression, insomnia, or suicidality; how it feels to face stigma and discrimination from people with no interest in understanding; how disheartening it can be to ask for help only to find none available; or the courage it takes to unravel past trauma though counselling and therapy.

Not everything will be easy to hear. I’ve shared a few examples in a post titled Four Things It’s Hard for a Mental Health Ally to Hear (And Why It’s Important to Listen).

Books and Online Resources

I’ve found a wide range of books useful, including memoirs and autobiographies by authors with lived experience, biographies, and books written for partners, carers, and friends. Of these, the final category was by far the least represented. There were books for partners, such as When Someone You Love is Bipolar: Help and Support for You and Your Partner, by Cynthia G. Last, and Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner, by Julie A. Fast and John D. Preston, but nothing specifically for friends. Fran and I wrote High Tide, Low Tide: The Caring Friend’s Guide to Bipolar Disorder to address that need.

I recommend the Stigma Fighters collections of short personal stories by people with experience of a range of mental health conditions. In four volumes, the Stigma Fighters anthologies are available in print and e-book editions. The stories are also available on the Stigma Fighters website. (You can find my contribution here.) The range of diagnoses, symptoms, and situations the authors describe helped me appreciate both the uniqueness of someone’s experience, and certain repeated or common themes.

Blogs, vlogs, and podcasts are another valuable resource, not least because they are usually intensely personal and tend to be updated frequently. For bipolar disorder I recommend Julie A. Fast’s blog Bipolar Happens, and her articles at BP Hope magazine and Health Central. If you want to learn about living with borderline personality disorder (BPD) check out my friend Aimee Wilson’s blog I’m NOT Disordered.

Two podcasts by mental health author and speaker Gabe Howard deserve mention: Inside Mental Health and A Bipolar, a Schizophrenic, and a Podcast. The latter, co-hosted by Michelle Hammer, “looks at life through the unique lens of people living with depression, schizophrenia, and bipolar disorder.”

Courses and Training

There’s a wide range of courses and training material, much of which is online and either free or low-cost. Some more expensive training, such as Mental Health First Aid (MHFA) or Applied Suicide Intervention Skills Training (ASIST) may be free or subsidised depending where you live and your personal circumstances. I’ve taken these and many other courses over the years and found most interesting and informative. You can find a selection on our resources page; we also have a list of online suicide awareness courses and podcasts. I particularly recommend Beating Bipolar and the free suicide awareness training at ZSA.

The Wider Mental Health Community

Fran had good connections with local mental health organisations, including the Maine chapter of the National Alliance on Mental Illness (NAMI) and Family Hope. I learned a lot from these but at a certain point I realised it would help to connect with similar organisations here in the UK. This led to me volunteering with the anti-stigma campaign Time to Change. I learned a great deal about myself in the process, met some amazing people, and made several lasting friendships. Volunteering gave me the confidence to become involved with mental health and wellbeing initiatives in my place of work. This opened opportunities to attend conferences and events, and become part of the wider Mental Health First Aider network.

It’s worth noting that some groups or resources may not be available to you without relevant lived experience. I was privileged to attend a few courses run by my local recovery college, including sessions on self-harm and wellness recovery action planning (WRAP). The college meant a lot to me, but it’s run by people with lived experience for people with lived experience, and I respect the fact I couldn’t continue attending.

I’ve found several mental health organisations helpful. No Stigmas offers excellent online ally training covering self-care, peer support, and advocacy. I joined Mind, Bipolar UK, and Bring Change 2 Mind for a broader awareness of news and issues across the mental health community.

Stay Humble and Open

As valuable as it is to educate yourself, it’s important to remain realistic and humble. No matter how many conversations you have, books you read, or courses you take, you’ll never really know what it’s like for your friend. They’re the experts when it comes to the life they’re living, the issues they deal with, and the support and help they need.

Recognise too that you’ll still get things wrong! This might be because you haven’t learned enough about what your friend is going through, or you’ve made assumptions that are wrong, inappropriate, or unhelpful. Treat each mistake as an opportunity for learning. If you’re honest and open about your mistakes you and your friend can both grow from the experience. I’m reminded of a conversation with Aimee, after I’d messed up badly.

I’m not sure if you agree, Aimee, but I’d say we understand there are times we will get it wrong, and that’s OK. It might not feel OK at the time but it will be when we are able to step back a little.

Definitely! And I think more and more we’re learning not to feel like total failures if we do get it wrong, and not blame one another for it.

It wasn’t the first or last time I’ve got it wrong, but we continue to be honest with each other when problems arise.

Learning About You Too

While you’re learning about what your friend goes through, don’t neglect your needs as a supportive friend. That’s something you’re learning about too. Even if you don’t consider yourself in a caregiver role, check out organisations such as Carers UK, Carers Trust, or government sites such as this UK page on support and benefits for carers.

Many organisations that support people living with illness have information and resources for caregivers, for example Bipolar UK, and Mind. Look for carer groups on social media too. Julie A. Fast runs two Facebook groups: one for partners of people with bipolar or schizoaffective disorder, and one for parents and caregivers. Hearing what other people in supportive roles have learned can add to your understanding.

I began this journey with no personal experience of mental illness, but learning what Fran and other friends live with has given me a much greater understanding of my own mental and physical health. I’ve explored this in such posts as Return to Down, THIS BOY GETS SAD TOO, and How International Men’s Day Inspired My First Doctor’s Appointment in 30 Years.

I’ve found that being open and honest about what I’m going through — both here on our blog and in private with friends — makes it easier to ask for help when I need it. It also helps my friends support me from a place of greater understanding. Aimee expressed this well in a recent conversation: “I’m glad you can be honest with me, Marty. No one can support a person who isn’t honest about how they feel, so you being open enables me to really be there for you.”

Over to You

In this article I’ve shared how I’ve approached educating myself about my friends’ experiences with illness. If you’ve been in a similar situation, what helped you most? What worked or didn’t work? Do you feel your friendship benefited? If you live with illness, what advice would you give a friend who wants to learn more about your situation? Do you want people to know, or does that feel like an imposition? Whose responsibility is it to educate people about what it means to live with illness?

Drop a comment below, or get in touch through our contact page.

 

Image by Tim Mossholder at Unsplash.

 

How to Keep Well during the Coronavirus Outbreak

By Quinn Brown

Photo of Scarborough beach chalets by the author

As someone who suffers with crippling anxiety, it has unfortunately heightened due to the outbreak of coronavirus which is affecting pretty much the entire planet. But I have been finding ways to focus on things that are not coronavirus related. Here is what I did to help myself which could help anyone who is in the same boat.

• Partake in some photography. I have a nephew who I have been using as my subject but you can also use objects or pets, whichever takes your fancy.
• Put some calming music on. I’m a Motown / Marvin Gaye kind of guy myself so that type of music helps to relax me when my anxiety starts flaring up.
• Talk to friends online or by phone. You can use apps such as Skype or Zoom or you can just use Messenger. Or if you want to hear a voice, a good old phone call is also good.
• Indulge in a good book! I’ve been reading Dracula by Bram Stoker and it is a classic!
• Blogging is one of my ways of venting about mental health and more so when my anxiety is rearing its ugly head. I use Wordpress for this and it’s really good!

I know not everyone is the same but the above is what I use to help me and sometimes I even do some gaming! Taking a long, relaxing bath is also a good way to relax. I could go on, the list is endless!

About the Author

My name is Quinn Brown. I am a trans man and I run my own LGBTQ-support group called seLGBTQ+ as well as helping my best friend and his wife run a mental health group called Talk Tonight Selby.

You can find me on Facebook and Twitter.

 

Coronavirus: How to Look after Your Wellbeing in Uncertain Times

There is a huge focus right now on the physical symptoms of Coronavirus (COVID-19) and how the virus will affect our day-to-day lives, but our mental health is important too. The following tips will help you, your friends and family look after yourselves and each other.

Stay Informed

It’s easy to be overwhelmed by all the coverage and statistics from around the world. It’s ok to take a break from news and social media if you need to but don’t totally lose touch with what’s happening and how it might affect you. Use reputable sources you trust to stay up to date. I have included a few links at the bottom of this article.

Stay Connected

At times like this it’s important to look out for each other. Check in with friends, family, and neighbours who might appreciate support or practical help. If you or they are self-isolating or unable to visit in person use the telephone or social media. No one is too far away to be cared for, or to care.

Stay Honest and Open

Involve your children and family in what’s going on and why things may be different from normal. Ask if they have any concerns or questions and answer as honestly as possible in an age-appropriate way. It’s ok to admit you don’t have all the answers.

Stay Focused

These are difficult and uncertain times but try and see this as a new period in your life that will pass, and make the best use of it you can. Focus on things that will support your health and wellbeing, especially if you have to self-isolate for a time.

Stay Safe

If you need support don’t be too embarrassed or proud to reach out to friends and family, or to professionals including your doctor, other professionals, or a helpline.

Links and Information

Here is a selection of websites and articles to help you support yourself and others through these times.

Coronavirus Overview (NHS)

UK helplines and support groups (NHS)

Looking after your mental health during the Coronavirus outbreak (Mental Health Foundation)

If coronavirus scares you, read this to take control over your health anxiety (Guardian)

Coronavirus: How to protect your mental health (BBC)

You can find further helplines and support organisations on our Resources page.

 

How to Use a Spreadsheet for Wellness and Self-Care

I rarely feel the need to record my self-care habits, but from time to time I find it helpful to monitor things a little more closely.

For the past ten days Fran has been staying with a friend in Arizona, after which she will visit another friend in Florida. Apart from a few days in between, she will be away from home for almost six weeks.

Although we stay in touch, vacations inevitably mean we are less in contact than usual, which can be hard on us both. I’ve also had a few things going on in my personal life that have affected me deeply. At such times it’s is all too easy to slip into feeling low, so based on my Wellness Recovery Action Plan (WRAP) I decided to use a wellness tracker to keep me in touch with healthy practices and activities.

My Wellness Tracker Spreadsheet

I first tried this back in 2013 when Fran took an extended trip around Europe. On that occasion I used a Google Docs spreadsheet and recorded brief notes about what was happening each day, how much exercise (walking) I did, any creative work such as working on our book, any reading I did (what book and for how long), and whether or not I meditated. This time I’m using an Excel spreadsheet to capture the following information on a daily basis: notes, mood, weight, eating, reading, exercise, creativity, water, and vitamins. Let’s look at these in more detail.

Notes

I use the notes column to record key events or feelings from the day.

Mood

I decided to record how I am feeling three times each day: first thing (plotted in blue), midday (orange), and evening (grey) using a six-point scale:

[5] Really good
[4] Baseline / positive
[3] OK
[2] Flat
[1] Low
[0] Struggling

I have written previously about what I mean by feeling flat.

Weight

I weigh at home each evening and track my weight in a separate spreadsheet (Fran and I have tracked our respective weights now for more than seven years) but I decided to include it in my wellness tracker to see how it relates (or doesn’t) to how I’m doing generally.

Eating

I have included two checks to help keep me on track and avoid any tendency to emotional eating (I am aware I tend to eat less if I’m feeling anxious). I record whether I ate healthily during the day; during the week this means yoghurt or porridge for breakfast and soup or a wrap for lunch. (Evening meals at home are generally healthy.) I mostly want to reinforce positive behaviours and activities, but I have a strong tendency to eat supper late at night. This is unhealthy for me and almost guarantees a gain in weight the following day. Including this in my spreadsheet holds me accountable and means I get to “fess up” to myself if I choose to indulge.

Water

This serves as a useful reminder to drink at least one large mug of water (approx 500 ml) each day in addition to my coffee, rooibos tea — and beer!

Vitamins

I take multivitamins plus minerals, vitamin B complex, vitamin C, and vitamin D tablets — when I remember to! Adding them to my tracker spreadsheet encourages me to take them first thing in the morning.

Reading

I enjoy reading but find it hard to settle into it at home. My best time for reading is on my lunch break at work, so this tracker serves as a reminder to do so. I have been reading an excellent book recommended by a friend: I Hate You – Don’t Leave Me: Understanding the Borderline Personality, by Jerold J. Kreisman and Hal Straus.

Exercise

As I have written elsewhere, walking has played an important role in my life for as long as I can remember, so much so that it was one of the first things I included in the wellness tools section of my Wellness Recovery Action Plan (WRAP). I take a walk after dinner most evenings, either to the local store for groceries or a leisurely wander around the neighbourhood.

Creativity

This tracker reminds me to consider some creative pursuit in my day, which usually involves writing or editing posts for our blog. This is in addition to keeping up to date in my personal journal, which I have kept for over four decades.

Observations and Conclusions

I’ve only used the checklist for a few weeks but it’s proving useful in a number of ways. I’m used to exploring my thoughts and feelings in my journal but this is the first time I’ve explicitly tracked my mood over time. I hadn’t realised how variable it can be throughout the day, how rarely it holds steady for more than a couple of days, and how quickly it bounces back after a setback if I don’t get in its way. It’s also interesting to note that my midday mood is much more stable than either morning or evening.

There’s something of a correlation between my mood and my weight, in that my weight came down during the first week when I was struggling a good deal emotionally. I think that’s largely because I’d started the tracker and was paying attention to what I ate, although as I mentioned earlier I tend to eat less when I’m anxious or stressed. As my mood stabilised my weight increased again. I think I allowed myself to overindulge in response to feeling better, especially with my late-night snacks. Not a healthy response!

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. There’s nothing wrong with “feeling what I feel” of course, as long as I don’t take it out on those around me.

All in all, using my wellness tracker spreadsheet has helped keep me on track with healthy behaviours and highlighted areas to focus on in the future.

As I finish this article, Fran is on her way back from Arizona. It will be great to see her for a few days before her next trip, but I find I’m curious to see how things will go — for her and for me — over the next couple of weeks when she is away again. Whatever happens, I will be tracking things closely and paying attention to my self-care.

Do you track your mood and self-care in any way? If you’d like to write about your experiences with wellness tools, check our guest blogger guidelines and get in touch. We’d love to hear from you!

 

A Landscape of Labels: Mapping Illness and Wellness

Imagine looking down on your country or continent from a plane. You are aware of the general terrain: mountains, lowlands, lakes and rivers. Perhaps you recognise some locations – places you have visited or heard about – but there are no lines or labels down there on the ground to distinguish this country or state from the next.

Now take out a map of the same area. The map is not the landscape, it is a model of the landscape, and it is full of labels. This area has a line drawn around it. The area inside is labelled so. If it is a political map, the line might define a country; this line a different country, this line a county, state or principality.

Select a different map of the same region. Maybe this one displays regions in terms of economic affluence, manufacturing output, average rainfall, or languages spoken. The area that was labelled “England” will now carry other labels. The labels applied depend on their definitions, and which maps we choose.

Maps and labels are incredibly useful. Without them we would, literally, not know where we are, individually or in relation to one another. Travel would be a challenge, travel planning even more so. On the political map I live in an area labelled “Newcastle upon Tyne” within the area labelled “England.” Fran lives in an area labelled “Portland” within a rather large area labelled “United States of America.” The map of languages will tell us that our nations each have English as their first language. We learn some interesting and useful things, but the labels do not tell the whole story. They are not who we are.

I find it helpful to think of health and wellness in a similar way. There is an area of the broad landscape of emotional, physical, and mental experience which on the diagnostic map is labelled “bipolar II disorder.” Parts of this area fall within a larger region labelled “depression.” If I choose a different map, some of the labels may be different. The “depression” region is larger, maybe. There is a region labelled “manic depression” which more or less corresponds to “bipolar disorder” but doesn’t match exactly. Another map has only two regions: “health” and “illness.” You get the idea.

Wherever we are on the ground the labels applied to us depend on who is looking at us and which maps they are referring to.

The labels of illness are useful where they help to define where we are on the landscape of wellness, and which treatments and approaches may benefit us. We can think of treatment as helping and encouraging us to move from our “regions of illness” and journey towards regions labelled healthy on the map. Fran might move in and out of areas labelled “mania” or “depression,” for example. If it is not possible to make these journeys for some reason, treatments can help us live more comfortably wherever we find ourselves.

Knowing that Fran is American (was raised and lives within the geographic area labeled “America”) helps me draw useful inferences about her cultural identity, and likely points of similarity and difference between us. Similarly, knowing Fran lives in a region of the wellness landscape labelled “bipolar” helps me to approach her with a degree of understanding and empathy. In both cases of course, it is possible to draw false conclusions, or apply the labels without reconciling them with who she actually is.

It is my responsibility to remember that she is not “an American woman with bipolar,” but an individual with her own unique, personal experiences and story. The same applies to how we think and behave towards ourselves. We can use the labels for what they tell us but take care not to over-identify with them.

Fran, you were saying last night that one of the most important things with us is that I don’t see you as “an ill person.” That I see the person, the whole person that you are. You mentioned that the labels (I think you meant labels like bipolar, cfs, fibro) are useful because they help you focus on why you have certain issues, and also because they qualify you for benefits. But you said it is possible to become too attached to them?

Yes Marty.. The labels help me care for myself.. They help me to understand why I do what I do sometimes.. The problem is if I make that my identity.. the way engineering was an identity for me before I got sick..

Misinterpreting the labels of mental illness is at the root of stigma and prejudice. We don’t have the time or the energy to get to know everyone we meet. Labels act as a shortcut. I suggest it is not possible to completely avoid this kind of thinking; we appear programmed to label the world around us and it is likely we could not function as social beings if we did not. The important thing is to recognise that the labels we apply say as much about us and the maps we are using as they do about the people we are labelling.

 

Ten Things I Learned about Myself Last Week

It’s been quite a week, one way or another. At times I’ve been as low and despairing as I have in months; at others I’ve felt grounded and whole.

Here are ten things I’ve learned about myself in the process. Maybe some of them will resonate with you too.

1. Things Are Shitty Sometimes

It’s rare for me to feel so low, stressed, or overwhelmed that it interferes with my day-to-day life. Mostly I move through upsets and difficulties fairly smoothly. But sometimes even my tried and tested strategies for making it through bad days fail me.

The best thing I can do then is accept I’m struggling. That’s not easy, because my life is generally stable and secure. I have a home, a family, a job, financial security, amazing friends, and decent health. What is there for me to feel overwhelmed by, anxious or low about? I’m aware of the danger such thinking presents, however. “I’ve no right to be struggling” stops people seeking the help they might need. So yes, my life gets shitty too sometimes.

2. Things Will Shift If You Allow Them To

When you’re in the middle of a bad situation it can seem like you’re stuck there permanently. The lost friendship or relationship is gone for good. The period of difficulty or illness or whatever it might be is never going to end or improve. There”s no hope. What’s the point of even trying to move forward?

When I get to feeling that way it helps to recall times in the past when I felt similarly stuck and remind myself that no situation, good or bad, is permanent. Do whatever you need to hang in there. Change will come all the easier if you’re not holding too tightly to the present situation. As American big-wave surfer Laird Hamilton puts it: “If you just get out of your own way... It is amazing what will come to you.”

3. Sometimes I Need to Put Me First

Friends sometimes ask me if they’re ever a burden. With complete honesty I can say that is NEVER the case. However, there are times when I get triggered or overwhelmed by whatever is going on my life. It’s vital I recognise when that is happening, pay attention to my boundaries, and take whatever steps are necessary to bring myself back to a more secure and stable place. The Wellness Recovery Action Plan (WRAP) workshop I took last year helped me understand this and I turn to my own plan when I start to struggle. I have done in recent months and did so again last week.

4. It’s OK to Ask for Help

Reaching out for help is a crucial step on the road back to stability. What that looks like will depend on your needs and the support network you have in place. I’m blessed in having friends I can be honest and open with, but even so it’s hard for me to “fess up” and ask for help. It gets easier with practice though, which is why that first step — which can feel like a huge leap of faith — is so important. I’m proud that I asked for the support I needed, and grateful to those who were there for me.

5. I Can’t Help Everyone All the Time

Sometimes I have to accept that I’m not the right person to help someone I care about, no matter how much I want to. It doesn’t mean there’s something wrong with me or our relationship, it’s just that I can’t offer what they most need. It’s harder when it’s someone I’ve helped in the past, but needs change and on a different occasion they might need support I’m unable to provide.

Maybe I don’t have the relevant skills, knowledge, or experience. Or maybe I’m unavailable or struggling myself so that I need to put all my energy and focus into self-care for a while. And of course this applies to others too. Their ability to help me depends on my needs at that moment and their personal situation.

All this might seem a sad state of affairs, as though we can’t rely on anyone to be there for us all the time, or rely on ourselves to be there for others. This is true (to pretend otherwise is unrealistic and unhealthy) but if we can face it with compassion the realisation can be deeply empowering. That’s why it’s important to have more than one person in your support network. There are four or five people I trust to be there for me. At any given time some may be unavailable or unable to offer the support I need, but I trust them to tell me if that’s the case.

6. Paying Attention Pays Dividends

There is a line in our book High Tide, Low Tide:

Give people what they need. Not what you need to give them.

This hit home hard recently when I failed to pay attention to what one of my friends needed. Instead of listening to what she asked me to do I took it upon myself to decide what was best. At another time it might have been no more than a minor annoyance to my friend. On this occasion, however, it was deeply unhelpful and hurtful.

And that’s the point. We can’t know when paying attention really matters, so make it your default approach. My friend and I have repaired the damage. We’ve talked it over and are closer for the experience. I’ve already used what I learned to help someone else who was struggling with a similar situation. I’m sad, though, that my friend had to pay the price of my learning something I ought to have known already.

7. Trust Is the Antidote to Fear

Some people wear worry as a badge of honour or as a sign of their commitment — “I’ve been so worried about you!” — but I know how toxic it can be. I learned this with Fran years ago. Don’t worry about me, care about me is the central message of our book High Tide, Low Tide and the foundation of our relationship. The key distinction is that worry is based on fear whereas caring is based on trust. I sometimes lose sight of this, however, as I wrote to a friend recently:

You’ve been so poorly lately and had so much going on for you that at times I have slipped into worry. The stressy, unhealthy worry energy that’s hard to avoid even though I know it doesn’t help anyone. Not you. Not me.

The antidote to fear is trust, and I’ve relearned that this week. I acknowledged what had happened and let go of my need to control things I had no business imagining I could control. I trusted that my friend is doing everything she can to be as well and safe as possible, and that the rest of her support team are there for her. And I renewed my trust in myself, to be the friend she needs me to be. No less, no more.

8. My Mood Is Dependent on My Relationships

A friend recently sent me an article by Angela Theresa titled Six Things Your Borderline Friend Wants You to Know. I was surprised how much of the piece rang true for me; especially the fear of abandonment, the need for validation, and the emotional intensity:

If you are my friend, I am loyal to you. You are beautiful to me. Your accomplishments are poetry. I think you’re fucking amazing. And you’re one of the best friends I’ve ever had.

My intensity has caused me issues in the past. I’m usually too much for people (or not enough, if I have been overcompensating for my tendency to excess). The downside is that I hurt deeply too, but I’m working with that. I still get it wrong more often than I like to admit but I have a small group of close friends with whom I feel safe and able to be myself. I am more grateful to — and for — them than I can ever say.

9. I’m (Still) Not Perfect

At work and outside it, I strive to improve myself. I read. I take courses and attend workshops. I talk with people. I listen. I’ve certainly learned a lot in the past week or so. And yet, I am still not perfect. (Sorry to disillusion you, Fran!) I make mistakes. Only last night a friend pointed out that I wasn’t paying attention to what she was saying. Rather than listening I was leaping in with suggestions and potential “fixes.” She was right to call me out on it and I am grateful to her for doing so.

10. Honesty Can Be Breathtakingly Beautiful

I write a lot about “honesty and openness.” To me these are essential components of any friendship or relationship. I’m not 100% full-on, in-your-face, open with everyone all the time, of course. That would be overwhelming and is what Brené Brown calls floodlighting.

I do, however, aim to be honest with everyone. As I wrote on social media precisely one year ago, “If you can be honest about what you need, that’s a real relationship right there.”

The past week has been characterised by honesty. I was honest with myself and others about the fact I was struggling and needed support. Friends were honest about how they were feeling, including letting me know when I’d contributed to their distress. (Thank you — how else am I to learn?) I was able to hear what was being said and take responsibility for my mistakes and my share of any misunderstandings and miscommunication.

Best of all, I’ve been honest with friends about how important they are to me, and heard how important I am to them. It’s not a sign of insecurity to value such moments. They can be breathtakingly beautiful. As I told one friend the other day, “I’m glad we can be honest with each other like this. It doesn’t happen with everyone and it’s lovely.”

 

Ten Ways to Turn a Bad Day Around

There’s nothing inherently wrong with having a bad day. It’s natural, I would even say healthy, for our mood to fluctuate in response to whatever is going on around us. On the other hand, no one wants to stay stuck in a rut.

Here are ten techniques I use when I’m having a rough day. Several of them feature in my Wellness Recovery Action Plan (WRAP).

It’s worth saying these are not fixes or solutions for anxiety, depression, or other mental health conditions although they might form part of a person’s wellness toolbox. They help me weather the ups and downs of life and I offer them on that basis.

1. Go for a Walk

I’ve written elsewhere about how important walking is to my wellbeing. It’s my go-to strategy when things are getting me down. Walking allows me to acknowledge whatever feelings are present for me, experience them, and then let them go. I sometimes use the “hot coals” technique I learned from Fran. I close my hand at my chest, taking hold of whatever feeling I wish to release. I extend my hand to the side and open it, palm down as I walk on. As silly as it might sound, it works. Try it next time you are feeling stuck.

2. Talk with a Friend

I’m fortunate to have a small number of friends I can turn to if I need to share what’s going on for me. I don’t find it easy to be vulnerable but with these few people I feel safe enough to be myself, knowing they will listen without judgement. There are few personal skills more important and healthy than the art of listening.

3. Write It Out

Writing features prominently in my Wellness Recovery Action Plan (WRAP). Apart from our two books and my blogging I’ve kept a daily journal since I was fourteen years old. For most of that time I wrote my diary each evening for the previous day. More recently I’ve started capturing my thoughts in the morning and at various times throughout the day. This means my diary is more of an in-the-moment account of how I’m feeling than an historic account of “how I felt yesterday.” Although journaling is an important part of my wellness regime I occasionally find myself trapped in an unhealthy cycle of introspection. To break the pattern I might challenge myself not to write any more about a certain person or situation until something specific changes.

4. Distract Yourself

Distraction is a core strategy of Dialectical behaviour therapy (DBT); others are self-soothing, improving the moment, and pros and cons. My friend and fellow mental health blogger Aimee Wilson has written extensively about distraction in a DBT context on her blog I’m NOT Disordered. According to Aimee,

Distraction can include writing and other creative activities, reading, beauty treatments, really anything that can take your attention away from what is bothering you. It is important not to overuse this or it can become avoidance.

I find distraction techniques help when I’m feeling stuck or overwhelmed, especially if other approaches aren’t working. Recently I’ve distracted myself by listening to the BBC News channel when I’m at work or at home in the evening. I can understand that for many people the barrage of world affairs might be upsetting or triggering but it stops me obsessing about things that are troubling me. Music can have a similar effect although I’m careful what I choose to listen to in case it exacerbates how I’m feeling rather than providing relief.

5. Escape for a Bit

Escape is similar to distraction except that the intention is to consciously set the difficult situation aside and find comfort and solace elsewhere for a while. Movies and television shows work well for me, especially when Fran and I watch DVDs or Netflix together online. For an hour or two we can put everything on hold and immerse ourselves in whatever we are watching. This doesn’t fix things but it allows time for my emotions and thoughts to settle and for fresh ideas to emerge. Taking a break from social media can have the same effect.

6. Reward Yourself

I’ve written elsewhere how important it is to recognise and celebrate our successes. That said, when I’m low or upset it’s hard to believe I’m worthy of reward because my default is to blame myself for whatever’s gone wrong. My friend Jen reminded me that no matter what’s happening I can take responsibility and reward myself for that.

What about playdates, Marty? Do you have playdates with yourself? Take yourself to a movie, or to dinner, or to a good bookstore?

This doesn’t work too well if my underlying mood is very low; rather than celebrate I’m likely to spend the time brooding. But if I’ve begun to shift things using some of the other techniques, treating myself can help move me forward.

7. Find Solid Ground

When I’m overwhelmed it can be hard to find a stable point of reference. Paying attention to my day-to-day routine helps but it’s not always enough to get me to a place where I feel grounded and secure. When other techniques fail I sometimes attempt to “jolt myself” back to a time or place when I felt more stable. Music from a particular period in my life can work, as can looking through old photographs or reading my journal from years ago. The aim is to get my feet under me again and then return to the present to face whatever is going on from that place of stability and safety.

8. Change Something

Changing even one small aspect of your situation can affect how you feel. When I’m low or stressed I take less interest in my appearance. Sorting out a nice shirt and my favourite tweed jacket in the morning can be all it takes to shift my mood in a positive direction. Get out of the house if you’ve been stuck inside. Try a different café or even a different table at your regular place. Drive or walk an alternate route to work or to the store. Talk to someone other than the people you usually turn to.

9. Accept How It Is

Despite having all the techniques at your fingertips, sometimes nothing can turn the day around. Processing, talking, escaping, distracting, rewarding — they all take time, energy, and focus and sometimes you just can’t. All you can do is accept you’re having a rubbish day and handle it as safely as you can. Cry, scream, grumble, isolate — whatever it takes to get you through. The very act of “giving up” can help shift your mood. It may not, but it’s worth a try.

10. Go to Bed!

If you’ve made it to the evening — or even the middle of the afternoon — and things are still looking grim, sometimes the best option is to turn your back on the rest of the day and turn in. Tomorrow is a new day and maybe things will look different in the morning.

I’ve shared some of the techniques I use to turn the day around. What works for you? I’d love to hear your thoughts, experiences and ideas!

 

S E L F L O V E

By Charlotte Underwood

I hate my body. I just do. I can remember looking into the mirror and hating my body as a child. Even as a teenager, I hated it. As an adult, still not a fan.

I’ve been so many different weights, my body’s changed with age. I’ve worked out, dyed my hair, got tattoos and piercings. But nothing makes me happy.

The thing is, self love is more than a mirror. It’s deeper. Self love is mental.

When you judge someone for their appearance, they remember it. When you call someone fat, they feel it. When you break someone’s confidence, they know it.

My low self-esteem comes from years of being called ‘fat’, ‘obese’, ‘ugly’ and ‘unlovable’, all by people I trusted. I actually didn’t hate how I looked, until someone told me where to look.

That’s important to remember, this whole epidemic of people wanting to change how they look, doing diets, hurting their body’s to be ‘perfect’... is because we created it. We made that. We made people feel this way.

So I don’t care about your personal preference of appearance. I don’t care about your judgement on fat, thin and in between. I don’t care if you have ideals. You. Do. Not. Shame. Someone.

If you don’t find someone attractive, that’s fine, but you don’t need to project that onto them. Let people live, let people be happy, let them enjoy the body that keeps them alive. Not one person has the right to set the standard of ‘the way we should look’.

And my friends, change your body if you want, but only if it’s really because you want, not because you’ve been pushed into it by judgement. Make sure everything you do for you, is for you.

#bodypositive #bodytransformation #bodyconfidence #beauty #lifestyle #wellbeing #wellness #recovery

Originally posted on Instagram.

 

About the Author

Charlotte Underwood is a twenty-three year old from Norfolk, UK. She is a growing mental health advocate and writer who aims to inform and education on mental health. The goal is to be a friend to those in need. She believes no one should feel alone. Charlotte blogs at charlotteunderwoodauthor.com. You can also find her on Twitter and on Facebook.

 

One Step at a Time: Walking for Wellness, Walking for Me

When I’m happy, I walk.
When I’m sad, or lonely or lost.
When I’m hurting, or numb.
When there’s too much to think about
Or nothing on my mind.
I walk.

Walking has played an important role in my life for as long as I can remember. So much so that it was one of the first things I included in the wellness tools section of my Wellness Recovery Action Plan (WRAP). It’s also made its way into my writing more often than I’d realised until I began writing this article. (The idea for this piece came to me whilst, wait for it, walking into work one morning a few weeks ago.)

My family never owned a car, so when I was growing up in Liverpool if I wanted to go somewhere it was catch the bus or walk. From the age of eleven I walked thirty or forty minutes each way to and from school, lost in my thoughts about whatever was going on for me at the time. In my late teens I remember going for Sunday evening walks to West Derby village and back, a round trip of maybe an hour and a half at my ambling, contemplative pace.

About that time I started going on the Ramblers’ Association (now The Ramblers) public walks every couple of months with my aunt and her friend. I loved the exercise and the sense of freedom, being out on the hills. The people were lovely but I mostly kept my own counsel and walked separately the rest. There was one exception, a lady whose name escapes me some forty years on. Her spirit is captured, however, in one of my poems from that time.

Song to the high hills

Take my hand offered
across streams
we jump
that trickle your laughter
down the savage fen.
Share with me one day’s
journey
in this weird land,
where even the spring shuns
the mark of our
trespass
and unnamed birds cast down
forsaken echoes
from the high hills above us.
Do you not see
the whole earth bleeding …
distant mountains burn
a venous red
and at our feet
the bare rocks haemorrhage,
oozing lichen up from unseen wounds.
Believe me,
cares that clothe us
city-bound
will fall
today
like autumn leaves
       that colour in your hair
come winter’s purge.
And yet, in all of this,
a little rain might mark my sadness
sevenfold
to court you but a day
—surely inhibition falters
as we share the innocence
of exploration together.

Innocence tempting revelation.

From: Collected Poems: 1977–1984.

I joined the hiking club at university but didn’t keep it up. I do recall one hike with friends across Ilkley Moor during a thunderstorm that painted the sky in all manner of crazy hues. Instead, I took to taking urban walks on my own, mostly early in the morning. A favourite route took me out of town to a park where I would sit a while by the lake before making my way back for lectures. One day I went further than I intended and got myself a bit lost. I remember taking my shoes off and walking part of the way back barefoot across a golf course in the rain. A different early walk, along a derelict railway to the local park, was captured in another of my poems.

The Bunch of Wild Flowers

this morning
as you slept in his arms
I wandered,
picked you flowers white as sonnets
early in the morning
where the lonely go
and lovers wonder)

stirring in your arms he
tasted autumn in your hair
ascent of flowers,
brushed away the cobwebs or a dream
and (plucked one throbbing rose as red as
kisses
early in the garden
where the lovers grow
within each other’s arms

And bore you welcomes wild
of flowers truer than all orchids
my love
this morning as you slept
in his arms I wandered
gathering poems deep as daisies
early in the morning
where the lovers
go,

From: Collected Poems: 1977–1984.

Urban or rural, walking for me has always been about space: space in which to think or not think, depending on what I most need at the time. It is my instinctive response to uncertainty, challenge, and loss. When I got the news that PJ, a dear friend from university days, had died my instinctive reaction was to get out of the house and walk. It didn’t matter where, I just needed to be moving. (Years later, that one evening of loss is imprinted on these local streets, although I’ve added many overlying layers of other days, people and memories in the intervening years.) A week or so later I took the day off work and went to the coast for a solitary hike, long enough to try and process the fact that my friend was no longer here. After my mother died I walked by Crosby Marina the evening of her funeral. The words that came to me are, perhaps, a poem. If so, it is the first I’ve written in many years.

Wandering
Wondering

How do I feel
What do I feel

Release
Relief

Re birth

Stillness
Silence

Un known
Un homed

Un tethered

Still
Calm

Centred (thank you

— Liverpool, March 26, 2018

I mostly prefer to walk alone but there have been times when I’ve taken a trusted friend along. One of my dearest memories of PJ is of walking her home in the snow one dark winter night. Years later I recall another walk in the snow with a different friend, when we got seriously lost on Wimbledon Common. The walk Fran and I took around Beaulieu in 2013 when we met in person for the first time was, quite simply, precious.

We walked, and talked, and took photos of the Abbey and gardens, and went on the monorail and the old open-top bus, and walked some more, and sat, and talked some more. It was amazing—and the most natural thing in the world. If we were a little shy it didn’t show. We were just two friends out together enjoying the day.

From: High Tide, Low Tide, The Caring Friend’s Guide to Bipolar Disorder.

Walks by the sea are special. I spent six months in Norwich on placement from university. One Sunday I drove to the coast with one of the other students for an hour or so walking on the shore.

(In the Depths of) Singing

Down the western reaches of the sea i
findme walking with a friend,
wind and seasalt wildly in the sky, you on
my mind. Late november: pebbles in a
wilderness of oceans and a fulling moon.

Something like the flesh of friends too
raw for touching walkwe. Two
investigating puddles. Our togetherness apart
we wander down our dreams while all the
waves one water can involve strike
sparks about our feet. From flints we
gather in the night.
We gather. In the

(o i love the waves that break upon
me like you)

nightly

From: Collected Poems: 1977–1984.

That memory sparks another. One morning long ago when I ought to have been at work but instead spent the day on the beach walking with a friend who understood that sometimes shared solitude is just what is needed.

A few years ago I paddled in the sea along Long Sands Beach at Whitley Bay here in the north-east. At first it was cold. Then my feet went numb. I probably should have come out at that point but I kept going to the point when my feet were hurting with cold. I got out of the water, dried my feet, and put my thick socks and boots on, expecting my feet to warm through within a few minutes. They took so long to thaw out I was beginning to think I had caused some serious damage. I have paddled in the sea several times since then, but not in quite such extreme conditions.

Over time, regular walking routes become saturated with memories. The best example of that is the walk I take each evening when on holiday at the Cumbrian cottage my family have rented for the past twenty years or so. So rich are the echoes of the people and situations I’ve brought with me in mind and heart over the years that I’ve named it Memory Lane. Fran has accompanied me on that walk many times via the magic of Skype. A few other friends have done the same.

I have done a few sponsored walks. When I was at school I organised a twenty mile walk for friends in aid of the World Wildlife Fund. I think only two of us completed the task but we did raise some money. More recently I have done the Alzheimer’s Society Memory Walk a couple of times, and taken part in the NAMI Maine Walk, accompanying Fran from 3,000 miles away. Last December I took part in the Jingle Bell Walk to raise money for children’s cancer charity The Chris Lucas Trust.

Returning to my solo walks and their place in my wellbeing, the best example is the walk I took almost every evening during the summer of 2013 when Fran was traveling in Europe. Those walks were part of my wellness plan for that period, which was the most challenging we’d faced as friends and one of the most traumatic Fran had ever experienced.

That wellness plan developed into the Wellness Recovery Action Plan I mentioned at the start of this article. It is a living document and will grow with me as my needs change, but I cannot imagine walking not being in there as one of my key wellness tools.

Well, this article has turned out to be rather long and rambling, much like many of my walks!

I will close with another passage from our book, because short or long every walk starts out as a single step, then another, then another. And where steps are concerned, size and speed are not always the most important things. The important thing is to keep moving.

As we like to say, baby steps are steps too.

This is one of our favourite [sayings]. It reminds us to stay focused in the present moment, to take life one step at a time, and to acknowledge that even the smallest advance counts as progress. Fran is very goal-oriented, and becomes frustrated if she seems to be straying off course or failing to make fast enough progress. In depression, this can reach a point where she despairs of ever achieving her targets or even progressing further towards them. At such times, “Baby steps are steps too” reminds her that she rarely stays stuck for long. She will try new ideas, or re-visit old ones, until something happens to move her forward.

From: High Tide, Low Tide, The Caring Friend’s Guide to Bipolar Disorder.