Downer

When  you suffer with anxiety or depression in any of their various forms, it doesn’t take much to get you down. In fact it takes a lot to keep you up!

I find this with a million stupid little things that turn a perfectly good day into a gloomy do! Usually its something that I’ve done that I’m annoyed at myself for, and I just can’t let myself off the hook about it. My husband can just cruise through these things and flick them off, just like water off a ducks back, as the cliche goes; it also helps that he doesn’t seem to make dumb errors in the first place! We have a joke that he’s always right…and it’s nearly always true! But I find myself berating myself over and over inside my head, mentally abusing myself for being so idiotic, self flagellating for my mistakes and lack of memory, or of thought, or of judgement. That just can’t make for a happy day.

I spent a lot of time with a psychologist when I first got sick and one of the main points of therapy involved reframing my thoughts, and interrupting a snowballing chain of thoughts. Reframing means to look at a situation and how you usually react, and try to consciously change your reaction to it so that you put yourself through less stress and hurt, and therefore are more well mentally. Interrupting a snowballing thought process means recognising when you’re starting down a line of negative thinking that is escalating to the dramatic and trying to stop it early, while its something that can be dealt with, before you’re almost to the point of a panic attack. I spent a lot of time working on this, and when you consciously and deliberately look at your thoughts, you do recognise a lot earlier where you can intervene and save yourself a lot of drama! Having said that, it does take a lot of energy to do this at the beginning. It gets to take a little less effort as you get more used to it, and you have less of these thoughts because of dealing with them in a better way. Eventually its more of a habit, but as soon as you think to yourself that you do it automatically and don’t need to put so much effort in, it can creep back in.

It is almost indispensable to have another person around who understands the work that you are trying to do with your head, and who can remind you what to do when you’re working yourself (unintentionally) into a bit of a tizzy! Someone who can remind you to breathe, that the drastic thoughts you’re having are just that: drastic thoughts; and of the techniques that you’ve learnt. I say it all the time but I have the utmost admiration for people on their own dealing with their beast. Kudos, and I don’t know how you do it!

Today started out as a great day. I had a good ride with my Wheel Women. We rode from Docklands to the pink lake in Westgate Park and back, and I had a superb raspberry jam donut (apparently it’s a “bombolini” according to this bakery) to top it off! I also had one of those San Pellegrino chinotto flavoured sodas in lieu of my usual Coke; that was not a highlight! Tastes like medicine!

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I was planning on doing a bit of extra riding today. I had planned to ride from Hawthorn velodrome to the start point of the Wheel Women ride, and then ride back there after the finish of the ride to add in some extra ks, but a little glitch with snoozing the alarm prevented me! Sometimes that would be enough to get me down, but I smiled through that mix up. I mean, just the fact that I wanted to do extra ks is a pretty good indicator that I’m sitting well up on the scale of blue.

I got to the start almost on time, and marvelled with everyone else at how stunningly beautiful Docklands and the water looked in the unexpected sunshine and after the rain. I really expected to get a bit wet with rain today after 2 days of LOTS of rain, but we lucked out. It was beautiful through the whole ride, and we agreed we could just keep riding and riding on a day like this where it was cool so we wouldn’t overheat, dry so we didn’t get cold with wet, not windy…perfect! Shame about me not getting up on time to do the extra riding; it would have been the ideal day for it. Oh well, let’s enjoy the ride I’ve got going on right now, instead of worrying about what I’ve missed. And there is some great re-framing and preventing of snowballing thoughts! And so the ride was just lovely!

And then, the error. The trigger.

Stupidly (it’s always stupidly by the way) I put my phone on the roof of my car.

I know!

Always a first. And last. Then some other first. Or another first if I just haven’t learnt my lesson. And so on.

3 blocks down the road from my car park, I went to put my phone in the holder and an adrenaline shot went right through my gut! I instantly KNEW what I’d done! On the bonus side, I’d been creeping along slowly since leaving the car park, hadn’t cracked 40kmph, maybe not even 30kmph…maybe it was still on the roof?!?

No!

Dulp!!

So back I go to re trace my wheels. I couldn’t get there fast enough; itching at every red light and pedestrian crossing until I got back to where I had been parked. There was a ute there now, so I got out and checked under it for my phone, once, twice etc. Then I carefully drove even slower where I’d driven already, retracing, scanning the street and gutters, wishing, hoping and more.

And back around again, and a third time! Nothing!! ARGH!!

And that’s how it starts. The adrenaline shot depletes a bit of your good mood, the persistent bad results of looking and not finding get you down more, knowing this is all your stupid fault hacks away at your confidence and suddenly you’re berating yourself and the day is not the same day it was before. It’s plummeting down through the levels of good into mediocre and before you know it, it’s not a good day anymore.

Although lately, I’ve been well, and more resilient. I knew this about myself, but this incident proved it without doubt.

I was SO bummed out over this stupid accident which should never have happened in the first place! How could I have been so thick as to put my phone on the roof?? I knew it was a bad idea, and I did it anyway. Who does that?? Typical! I make a rule, and I break my own rule, and of COURSE this is what happens! It’s okay to put the keys on the roof, because you can’t leave without them. But your phone? Idiot!

This is how my thinking goes, left to its own devices. Berating, accusing, bullying, incredulous of myself, throwing insults.

This is where the challenge lies. Putting my psychologist’s knowledge into practice in this moment and not letting the snowballing of negative thoughts get off to a head start. Re-framing the thoughts: instead of calling myself an idiot and stupid and dumb, realise that accidents happen (even if it’s often and always to me!) and this was just that, an accident, and give yourself a break!

So, having proved that my phone cannot be found and doesn’t seem to be anywhere that it should be, I head home. On the way I think of half a dozen reasons why having my phone right now would be so good: to find out the best route home, to take a photo of the city shining in the sun, to pop a starter note for this blog into my notes section, to check my calendar for what else I’m meant to be doing today, to use the Optus app to put my phone plan on hold, to call my hubby and let him know about my phone!! It really is my right hand and its going to be a bit painful without it. Stupid, stup…no, we agreed: not stupid; unfortunate. Accidental. Breathe.

But then, halfway through sliding down the blue scale into the depths, I slowed up and stopped. I stopped. That hasn’t really happened before. And it wasn’t like I put a heap of work into it, into stopping my thoughts. But my head is just in a better place lately, and this didn’t seem to be as big of a deal as similar events have been before, where I could wrap myself in guilt and grief for a whole day. Now I was stopped somewhere around the “okay” mark, still realising the inconvenience and bother I’d caused myself, but not fatalistic like many times before. What is this new feeling? Is this being well? Could it be?

I got home and flicked a message off to hubby about being out of phone contact. Then got out one of my comforters and I was pleasantly surprised that before long I was smiling and feeling quite serene about the whole thing! What is this? It was still annoying etc but it didn’t feel like it was taking up my whole world with distraught stress but like it was just one part of the picture. I like this feeling!

I believe that this is how you know you’re well. You can recover from events that happen, instead of collapsing into various levels of despair and misery. I’m not sure how this state came about, but I feel like the chemicals in my brain are finally aligned and things are just easier. It’s very exciting!! To say the least.

As to what happened with my phone? Hubby told me all the things I could do and so I went through Google’s ‘find my phone’ function online (just search for it) and I used that to lock my phone, to put a message on the lock screen to say please return my phone and to give the number to call, and to track my phone. I have to say that was the most satisfying and frustrating part, watching someone driving my phone along. It travelled the Bass Hwy towards Phillip Island via the koala park, and then stopping at the Nobbies, and I was unable to do a single thing about it!! But it was awesome to be able to watch them in the first place. I made a full report to the police and they were very helpful. But then my husband got a phone call from the person who picked it up: turns out they were a coach driver who found the phone in Docklands super close to where I’d driven past, and they planned to bring it back the next day! How kind and honest! So all’s well that ends well in the end. My husband biked from his work into the city in his lunchtime to pick up the phone, and everything is as it should be once again.

Lessons to be learned:

  1. Do NOT put your mobile phone on the roof of your car in any circumstances!
  2. Do leave your GPS function on so that you can track your phone if you ever lose it, it was accurate down to 6 metres at one point
  3. Do be aware of Google’s find your phone functions
  4. Ideally always have your screen locked, but know that you can lock it remotely in an emergency
  5. One day, after so much pain, stress, medication, therapy and time, you will be well again. Believe.
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Perspective

[Written in 2014, finally finished today!]

One of the techniques that I’ve been working on is looking at life differently.

My psychologist first got me onto this with a technique called cognitive behavioural therapy (CBT) which tries to redirect thought processes.

For example, people with anxiety and depression often catastropise. I would have a thought like, I’m not working at the moment, which would then lead to, I’m not contributing to our finances, my husband is looking after everything and I’m doing nothing, and, what if I never work again and become a vegetable, and I’m totally useless and live forever with other people having to take care of me, and hating me!!

Obviously, to an outsider this is a drastic way of thinking and a rapidly snowballing thought process! Which is not even factual, as I’ve never had it suggested to me even once that I will be doing anything but returning to my previous active, contributing life. Neither is it at all likely! But depression just has to nut out the worst case scenarios and get you to think, ‘what if’?! And the thing is, at the time, you can’t see it for what it is. It feels totally real, and scary, and awful even though other people may dismiss it as illogical.

Depression, does not have logic.

But depressive thoughts can be changed. It isn’t easy, but if you work at it in the right way, you can slow or stop the snowballing and start to prevent the catastrophising.

Around the same time as I started to see my psychologist, I was already involved in the 100 Happy Days photo challenge that I’ve talked to you about before. Happy. Depression. The two don’t naturally go hand in hand. They’re kind of opposites. Making this a real challenge! This involved, every day, taking a photo of something that made you happy. I knew I was suffering generalised anxiety when I took it on, and during the course of the challenge got diagnosed with depression and bipolar.

Finding something in the day that makes you truly happy takes a real change in thinking. It takes noticing the detail in the day, the little things that are often overlooked, appreciating what is often taken for granted.

These were not the happiest days of my life! Needless to say. In fact, some of the worst days that I have ever experienced were smack bang in the middle of the challenge. But did you know that it never once crossed my mind to not go on with the challenge? I never once considered not doing the challenge, even when I was sitting in the emergency department beside myself with suicidal thoughts and in so much mental pain that I didn’t know how I would live. My happy day photo that day? I was wearing my favourite dress with the huge rosettes around the hem and I was eating my favourite Snickers bar!

There’s always something. That’s what the challenge taught me before I was even conscious of it.

Depression is called depression because it’s depressing.

It lowers you down, it lowers your mood, it lowers your mind. It’s the mind version of walking along in life looking at the gutter. All you can see is the dirty, the trashy, the boring, the bleak, the wasteful, the dead, the mundane.

I’ve always been a stare at the ground in front of me and watch for snakes kind of girl. You know, just in case. But now, instead of physically looking down and stomping along to the train to go to work, I started looking up, casting my eyes around me and began to see all kinds of things in that 10 minute walk alone. The wood ducks nibbling on grass beside the path; never even knew they were there! How beautiful the pond looked shimmering in the morning like. How green was the grass, how blue was the sky. How beautifully kept that lady’s roses are so close to busy Box Hill Central!

And it got me mentally looking up. Instead of snoozing my alarm until the last possible minute, and dragging myself begrudgingly out of bed, I started to wake up wondering what I would see today that would make me happy. There is no mistaking that my mental health was in a dire situation, but at least for a few moments of the day there would be something that I found that would give me a glimmer of a smile, a bit of satisfaction because I found it! That thing that could make me happy. And the memory of it could be taken with me throughout the day. It truly proved to me that if you put yourself to the effort of looking up, mentally or physically, you will surely be rewarded.

So in an effort to lift one’s mind’s eye to a more beautiful view we try this technique of purposefully, intentionally looking up. Some call it mindfulness, some call it practising gratitude, some people call it thankfulness; doesn’t matter what it’s called, it’s a thing. A method to get out of the grunge and into the pretty meadows, or paddocks since this is Australia.

Probably this is the most powerful method of changing perspective, although I’ve way under used it! I came to it as a compulsory part of my insurance, and having someone tell you that you have to do something that you think is stupid is never a good starting place!! But I had to change my thinking. I had an amazing logical sensible teacher who was on my wavelength, and the lessons I learned were incredible!

Mindfulness teaches you to slow down, to take more time to take in the things that we usually just rush by. By doing this, you get greater fulfillment out of life.

I’ve also always been a person to try to scrape the most out of every second, minute, hour, moment. I always got up at the last possible moment, showered for as long as possible til I absolutely had to get out, dressed as fast as possible and left the house only when leaving a minute later would make me nine minutes late instead of eight! Because I was always rushing I’d often leave my lunch, my wallet, my phone, my brain at home! I always squeezed the most time possible into my breaks, felt jibbed every time I had to go back, put off going back to bed so I could fit more into the day. Etc, etc!

But anxiety made me realise that this is not a feasible way for me to live anymore. The extreme anxiety I feel when I’m rushing, late, overcommitted is so awful with the nausea, the sweating, the palpitations. And mindfulness reinforced this again. What if you could walk slowly and calmly without a care in the walk on your way to work? How would that be? Wouldn’t that be nice? Mindfulness is kind of addictive in it’s own way, because it’s highly rewarding to your brain. Of course then there’s the real world, but for a little while, you are in total control and that is amazing!

Mindfulness also teaches you how not to judge yourself and others!! Could there be a more powerful tool than this? In mindfulness, you sit with yourself, which sounds funny to start with, but you just sit with your thoughts and all you have to do is acknowledge each thought as it comes, without it being “good” or “bad”. Do you know how often we are bagging ourselves out in our head and we don’t even consciously know it? It’s terrifying! That’s the worst 3 second wrap ever, but I do highly recommend it, and not only for people with mental health disorders; it can help with a lot in life.

Changing perspective.

Looking for the happy, the good, the joyful things in life.

Some people call it being positive, but I’m not a fan of that description. I feel like being positive is ignoring the reality and the badness, and trying to paste over it with being chipper and perky and upbeat!! Maybe that’s unfair but I feel my arm hairs raise and my spine tighten when positive comes up!!

I prefer to fully acknowledge exactly what is present, what the problems are, and try to work with that to change it for the long term good, not for the short term glossing over it. I’m sorry if that’s offensive; but I feel that if the problems aren’t realised, the treatments won’t be effective so it’s important to be honest.

Changing perspective is hard. It’s hard. It takes effort. It takes perseverance. It takes time. It takes motivation. It takes emotional energy, sometimes physical energy.

Most of these are the things that depression takes away from you. Before you even have a chance to notice, depression whisks away your energy, motivation, ability to exert effort. And leaving you a blob sitting in a chair, staring at a wall wondering what to do next, and how on earth you’re going to do it?

Looking up. Changing perspective. Mindfulness. Gratitude.

The outcomes are so worthwhile if you can put yourself to the trouble.

I highly recommend engaging a psychologist, a mindfulness coach, a doctor trained in CBT because it’s much easier to be guided than to have to do it all yourself. If the session is pre-booked and all you have to do is turn up and be coached, you are already on an easier path, from someone who knows.

Of course you have to participate, and at some point in time you will have to do it on your own, but let’s focus on getting started and you will absolutely benefit from whichever path you go down.

100 happy days is different. You can do this on your own, and unlike me doing it all through Facebook, you can do it by yourself in a notebook and nobody has to know. I can’t recommend blurting everything about your journey onto Facebook like I did; it worked for me, but not so sure about all the poor readers, and it might just not be something you are comfortable with. It’s your call, and there are lots of other options out there.

I wish you well on your perspective changing journey!

Voices

 

I’m friends with the monster that’s under my bed

Get along with the voices inside of my head

You’re trying to save me, stop holding your breath

And you think I’m crazy, yeah, you think I’m crazy

Well, that’s nothing

-Monsters by Eminem feat. Rihanna

 

I love this song called Monsters by Eminem with Rihanna and always sing along when it comes on the radio while I’m driving. The chorus mainly, I’m not skilled enough to rap along with Eminem! “I’m friends with the monster that’s under my bed”. To be friends with whatever our own particular monster is; what a great goal to have!

To accept that I have a monster in my life, to accept that it isn’t going away and can’t be gotten rid of, to accept that it will always be right there lurking under the bed is one of the biggest parts of reaching remission with mental health disorders. Acceptance is key.

That’s what I’ve been told by my therapists and I really do think that this is true. I’ve seen enough patients with mental illness, mostly schizophrenia and sometimes bipolar disorder, and every now and then depression, anxiety or panic disorders who do not believe that they are unwell to know that believing the diagnosis and accepting the need for treatment is the biggest advantage you can have on your side. From then on out, having a good relationship with your doctor, having faith in the treatments given and doing what you can for yourself are added bonuses towards successfully managing your condition.

Fighting against the diagnosis, disbelieving the doctors, resisting the label, not wanting to accept the idea of illness takes so much emotional energy, so much mental energy and makes you prey to so much more time exposed to the condition that is ravaging you. It can also make your condition harder to treat once you finally succumb to the idea of needing help as it has had so much more time to get a strong grasp in your mind and the symptoms may be a lot more advanced. You wouldn’t do this to your body if you had diabetes, leave your body exposed to high levels of blood sugar damaging your blood vessels and nerve endings while your organs starve for sugar. So why do it do your mind?

Because at the end of the day, mental illnesses like diabetes or thyroid disorders or heart disease are conditions that are not curable, in the sense that they never go away but can be well managed. Bipolar disorder doesn’t just pop up then vanish away again. But it can be managed away to the extent that it no longer controls your life and so that people around you have no idea about your condition, and maybe you even forget that you have this monster.

Here’s to becoming friends with whatever it is that scares the pants off us! To becoming friends with our monsters.

 

[ I ] Get along with the voices inside of my head”

 

I don’t have voices inside of my head.

That sounds like a statement of denial, but it isn’t. I’m just telling you a fact about me. Trust me; I’ve been thoroughly checked for voices! By my GP, my psychologist, two psychiatrists and a number of nurses. And myself, just to quintuple-check.

I mean that I don’t have voices in the sense that most people expect voices. I don’t have auditory hallucinations such as people can have if they suffer from schizophrenia, psychosis, some forms of bipolar or delirium. I don’t hear people who aren’t physically present telling me things, commanding me to perform certain actions or speaking to me through objects like the radio or TV.

But I’ve come to learn about other types of voices that can be just as damaging. The inner voice. Everyone has one, to whatever extent they allow it to be heard in their own mind. The little voice that chats away in the background carrying along beliefs, ideas, thoughts, judgements, criticism and hopes and dreams. And sometimes not only one voice. There’s my inner voice that carries the weight of history, experience, self esteem and knows me well. There’s the inner voice which is other people’s beliefs projecting as their voice and most importantly, my new inner voice!

One of the things I’ve been trying hard to work on during my recovery is to change my inner voice, or develop a new inner voice. Depression and anxiety can both have a large self critical and other people critical component. When my current voice criticises or judges or makes snide remarks, I try to correct it. Not with judgement, or criticism, or rudeness. If I took that approach, my new voice would be as difficult as my current voice!

So when my old inner voice sparks up a thought train that I don’t want to follow, my attempt is to gently override it with a better thought, or kindly redirect it. When a critical thought comes to mind, I try to tell it, no that’s not how I want to think about people anymore, and then I try to impose a better thought onto that thought to overcome it.

Maybe the idea pops into my head that that girl over there is fat. But that’s not how I want to think about other people, and I have to bear in mind that I myself can be classed as fat, so instead of thinking those thoughts about her and me, I’ll think about her beautiful hair and her lovely smile. Which will make me smile, and enjoy these nicer thoughts 🙂

It is not easy! It takes a lot of hard work to get along with the voices inside of my head! Being friends with the monsters is much easier for me! I don’t know if everyone has the same difficulty, but it’s taken me a lot of work to get to where I am and there’s still a way to go. I know consciously exactly how I want my mind to be, but it doesn’t change just for me wanting it to! It takes practice and repetition and solid thinking!

But at least I’m on the way to getting along with my voices, a little progress is better than no progress!

Recovery

 

“You will get there when you are meant to get there and not one moment sooner. So relax, breathe, and be patient.” -unknown

 

Last Wednesday was an interesting day for me.

Another new start, another new pursuit, another new hobby, another new lifestyle angle.

I began a new journey, a new pathway towards I don’t know what exactly. I participated in my very first formal mindfulness class.

When I was in my first year of university and had my first panic attack, I went to see the campus counsellor. She was a really sweet lady and helped me through some difficulties, frustrations, emotional strain and odds and ends in our one-on-one sessions. She also got me involved in a lunchtime class where we tried meditation and mindfulness as stress reduction methods.

I don’t have a very clear memory of that time; I had a lot going on I guess. But I do remember one mindfulness exercise that we did with a mandarin and I’ve gone back to that a few times over the years since then.

This year and last year while I’ve been seeing a psychologist pretty frequently the idea of mindfulness has come up briefly a few times and the last time I was able to borrow a mindfulness CD from my counsellor by well known Dr Craig Hassad, lecturer at Monash University. That was a good reminder of what mindfulness is and how it can be used.

So now I’m doing this class for two and a half hours every Wednesday for eight weeks. So far, I’m very happy. The lovely group leader is a practical, kind lady who has made me feel very at home and the other members of the group all seem like they are very nice as well. I was a bit worried that it might be really alternative and other worldy, like rituals and incence and weird stuff; but thankfully its all very normal and logical and helpful.

We arrived on a freezing cold morning to a delightful old church done over for other uses. Not only was the heating on high but we were able to help ourselves to lovely fleece blankets that had been warming in front on one heater to keep ourselves soft and cozy! Plus cushions and pillows; how lovely! Off to a good start!

What I’ve been thinking about most is not the course so much, but how I introduced myself to the other ladies; no men in this particular course. My introduction of myself was that over the last year or so I’ve been progressively diagnosed with anxiety disorder, depression and now bipolar disorder. I told the other ladies that I’m now in the recovery phase of resting, starting medications, having doses changed and getting used to medicines.

Recovery phase.

Interesting.

When I got home that day I thought about that a bit more. And realised something. I tell other people that I’m in the recovery phase; resting, medications etc but I don’t let my brain get that memo. I’m telling myself a whole other message, which is hurry up and get your stuff together because your life is waiting for you and it won’t wait much longer!

See? A whole other message!! And quite a lot more stressful! So time to help myself out.

Danika, you are in the recovery phase.You can rest, you can allow time the healer of all things to have its place to work. You can allow medications to take their effect, you can attend your appointments with your doctor, psychiatrist and psychologist. You can go to your photography course, your mindfulness course, to free meditation class, on bird watching walks, on interesting day trips and excursions. You can take naps when you need them, rest when you are tired, socialise if you have the energy.

Can you take five minutes to realise how amazing this is? You have free rein to do whatever you feel like to help yourself and heal yourself!

Don’t think about how you can’t do everything that you want to, don’t worry about your limitations, don’t get put off by tiredness or weakness or feebleness. You can do whatever you feel like and are up to with whatever resources you have. That is amazing!

And make a new attempt at perspective, please. You have been on six different antidepressants on less than a year, each one taking a month to six weeks to show its full effect then needing to be washed out and a new one started. You have been on varying doses of a mood stabiliser since March and each dose or formulation change had its own issues. Remember that you started lithium not even eight weeks ago, and that the last dose change was just three weeks ago!

Three weeks. That’s not forever ago, you aren’t taking forever to get better, please remember that you are still taking step after step and every change takes some kind of toll, so you need time to roll through each new wave of turbulence.

 

 Don’t even think about work.

 

Those are the words from the psychologist provided with my insurance.

 

Don’t even think about it. Just relax, take it easy, take your time, get yourself better.

 

At my last psychiatrist visit we checked in again about my colossal weight gain and high cholesterol. He’s still thinking about putting me on a cholesterol lowering drug.

 

Its pointless trying to diet and exercise right now with all the changes in medication. You aren’t going to be able to do much about it until we get you stable.

 

Stable. We aren’t there yet. You are still in the figuring out what’s what and getting everything straightened out stage. You’re still adjusting to having this condition, and having to take medication twice every day and having to take life at a different pace.

But as always, instead of taking the psychiatrist’s words face value, I debated with myself and am still debating whether using that information is a cop out, and maybe I can do more about it than I think, and maybe I’m just being lazy and not trying etc. Typical!

But no, rest, relax, take advantage of this amazing time that you have. You’re young, you have time to fix your cholesterol, time to fix your weight, it doesn’t have to happen three weeks after changing doses of lithium! Sure, if you have the emotional and physical energy you can small changes now, but let’s resolve to postpone the big changes until 2015!

You’re in the recovery phase. You’re only job right now, is to recover. So off you go, recover. Rest, relax, enjoy, feast on this unexpected piece of time that’s been given to you, make the most of having very few responsibilities and hardly any “have to” claims on your time. Recovery.

The Brain

[Author’s note: written last Thursday]

Today I…

…Hmmm.

I just realised that a lot of my writing and thinking starts like this.

That’s one thing about being home by yourself for months; you get to thinking about yourself a lot! And not so much about others.

Plus, you know, the whole life-changing nervous breakdown thing that triggers a lot of soul searching, heart searching, mind searching etc.

Plus being in therapy which encourages looking into yourself and understanding yourself and changing yourself. Plus seeing doctors regularly who ask you about yourself and want an answer about yourself.

Don’t know whether it is bad or good but it is what it is. I’m just noting it for my own reference really. Without judgement, just like my psychologist, mindfulness teacher and gratitude life class coach would say!

So today I went to a free organ concert.

This is something that I’ve wanted to do for a while now and haven’t gotten around to. It’s actually something that I’ve wanted to do ever since school camp to Sydney way back, not sure which year; probably about a decade ago though!! We saw the majestic organ at the Opera House but never got to hear it played. So the idea of hearing an organ concert is something that has been lurking in the back of my brain ever since.

And now it popped up for free! Can’t beat that!

So I went along today and took in the concert.

Annoying thing is, I’m not sure if I enjoyed it. Annoying, frustrating, irritating, worrying, concerning,interesting; pick one, any one.

My logical brain appreciated the size and the grandeur of the organ and the work that went in to building such a large musical instrument. It registered the admirable fact that the organ has been in place for a long time and still rings true thanks to dedication of many people. It realised the lovely surroundings from where I sat including the bright colours of stained glass windows, lovely wooden furniture, carpets and heating that made the environment comfy cosy on a freezing cold rainy day. It took in the detail of paintings and carvings and settings that were meticulous and intricate.

My rational brain heard the satisfying chords of the music played and admired the skill of the organist, and the patience of the girl sitting by to turn pages. It was interested by the variety of other people with a like desire to hear organ music in this day and age, and the ongoing support of obvious regular attendees. It was intrigued by the range of notes and variety of styles in which the organ could be played; impressed really to hear fast furious pieces together with traditional classical music and lyrical hymns. It felt obliged to be satisfied overall because really, wasn’t I ticking off one of my longings?

My physical brain was engaged in making sure that I was comfortable. I overheat very rapidly these days because of my medicines so all my coats and scarves were off. But just to be sure my physical brain checked and checked again and found that I was in fact sweating. Seriously, it was 8 degrees outside and I had just walked into a mildly heated draughty room and I’m wiping sweat off my face! Argh. Moving on, my brain was okay with the seating, the position, the view. It was surprised to find the seats in fact very comfy for an old building, and the view to be very nice.

So my brain goes on, looking, checking, assessing, approving and appreciating.

But is it enjoying? Today I’m just not sure. Usually I can feel it; happiness, joy, enjoyment. But today is one of those days where everything is in place, but I just can’t quite get to where I think I want to be.

Is it the medication, is it the condition, is it just an off day? Was it my lunch not sitting well, the seat slightly skewed, the conversation I just had? Was it my planning for tomorrow, my list of others things I’d like to do, my thoughts on dinner?

I think it will take more time and experience before I know the difference and can say for sure which is which.

I’m glad I did what I’ve wanted to do for so long. I’m sorry I didn’t quite get out of it what I thought. Maybe my expectations were not aligned with reality or maybe today’s just not my day. At least I have the blessing of being able to try it again sometime since the concert is a recurring one. A lot of times we don’t get opportunity a second time so that’s definitely in the plus column!

Saturday Shoutout

I have hedged around this and hinted at in and mentioned it obliquely but it’s time for some straight speaking about an important part of my life.

My peeps.

Specifically, my psychologist, my psychiatrist and my GP.

My support crew.

Without them, I don’t know where I would be. Literally and figuratively. Would I be in a psychiatry ward in a hospital? Would I be in rehab? Would I be doing a lot worse than am I now? Would I be a vegetable in bed? They have stood by me, held me up, dealt with me, kick-started me, bucked me up and saved my life.

I don’t say this lightly.

They saved my life! They’re that important.

Everything I say here has what to me is an obvious unwritten addendum: as well as my husband. He is the most important person in my life and has been my most supportive friend through every hill and valley, through every new discovery and every boring pushing-on day, through every heartache and excitement. He is so critical in my life but there are times in life when you need to call in the experts!

And these times have been the last year!

My aim today is to give a shout out to my current team because I truly do owe my life to these people. There are other people who have also been hugely helpful to me and I acknowledge them mentally; they might get a write up another day.

Starting with my local doctor, my general practitioner or GP, Dr Richard Young.

I came to see him accidentally after a false start with the GP that I used to see back when I was at uni. She charged a fortune and didn’t give me any confidence that she knew what she was doing. In fact she said to me, I’ll ask my colleagues and check some textbooks; can you come back next week? Well no I couldn’t wait a week, I needed help now! I complained to a colleague at work that I didn’t know where to start looking for a good GP and that I wanted to find one close to work.and who didn’t cost me so much and she handed me a business card for this doctor. I rate this as the best recommendation I have ever had and am always so thankful to her for this!

I didn’t tell this colleague why I needed to see a doctor and yet she gave me a recommendation for a doctor with a special interest in mental health, and who sees many patients with depression and anxiety. That was lucky number one. Lucky number two was the location of the clinic, within a 5 minute walk from work! Could anything be more perfect? I could easily slip away from work in my lunch break, between discharges, after ward rounds etc for my 15 minute appointment. And lucky amazing number three is bulk billing for mental health patients! That is, no fee to pay for each visit! Thank you infinity for this amazing policy that has benefited me and my husband so much!

Richard is a young enough doctor to have passion for his job in spades, old enough to have experience and knowledge and confidence, and has bedside manner and compassion like you dream of in a doctor!

His knowledge of the health system is unsurpassed. I have attended many different GPs in my old clinic last year as well as here, and have never experienced such thorough care! I have cervical migraines; I get Medicare subsidised visits to a physiotherapist. I’m gaining weight on medication; I get some of those visits changed to see a dietician. I have deficiencies; I get treated. I have risk factors; I see the practice nurse to develop a care plan for how I will reduce my risk factors. I have depression/anxiety and need help managing my symptoms; I get ten Medicare subsidised visits to a psychologist, and when I use them all up, I get more! We need help managing the medications; I get Medicare subsidised visits to the psychiatrist. And most importantly, when I’m suicidal he doesn’t let me go home; he sends me straight to the hospital where I can be cared for and a new plan can be made for my treatment.

You get the picture: this doctor is amazing! There is nothing I have that he can’t fix me up with the appropriate health professional or service!

After 8 months of seeing Richard once a week every week I have no complaints! I have had to wait on occasion, I have had to be rushed through on occasion but I have proved abundantly that when I have acute and severe needs, I will be given as much time and attention as I need and be cared for exactly how I need. How I want not always; but always how I need. I think you do need to give credit where it is due and understand the limitations of the medical system and within those limits I have been wonderfully and carefully looked after!

I would absolutely recommend Richard to anyone!

It is due to Richard’s amazing insight and care that I was first given a referral to see a psychologist. Unfortunately the first lady I saw did not connect with me at all, and in fact I left worse than I arrived!! Crying going down the steps is not the right way to go. So Richard promptly organised for me to be assigned another psychologist and I have loved her since the first meeting!

Patty Sabbagh from the Nexus Psychology group is her name and place.

She has seen me through all kinds of scenarios. Happy, sad, suicidal, excited about life, demotivated, purposeful and everything in between are the ways that I have turned up at her door and she has adapted and given me real help and hope and a new way on from every problem! She has helped me to deal with all kinds of issues, she is so resourceful and like a good friend. Sometimes I have gone and its just been a good chat with an understanding fellow human that I needed, and she has been a listening ear, a shoulder to cry on and a clever therapist able to give me a better way to fight on. A mother, a friend, a support; all labels I could give her and more!

She listens and considers and recommends the best approach. Sometimes talking about it really does solve the problem, sometimes a new way of looking or thinking about an issue is needed, sometimes there is need for meditation, or mindfulness, or cognitive behavioural therapy. Whatever is needed, this talented psychologist and counselor has the remedy!

Anyone in trouble needing someone to help would be well advised to seek the help of Patty from Nexus Psychology or one of her colleagues.

Lastly my newest support crew member, and one who has changed my life. Another big statement but well deserved! My psychiatrist, Dr Ian Katz.

He entered later in the picture because I initially saw a psychiatrist as part of my outpatient follow up from being in the emergency department of the local hospital. He was the one who suggested cautiously that bipolar was indeed a possibility and who first started me on a mood stabiliser. However his role is to see patients in the short term then send them back to their GP to be managed. Which is what happened.

My GP and I went along with the plan for Seroquel and for a while we seemed to be winning. Then that started to fall apart and my GP gave me the referral for Dr Katz. He picked up the pieces, made a sensible picture out of it all and gave me a ‘wait and watch’ directive and asked me to come back in a few weeks. I returned with a history of the most manic-like state that had happened to me so far coupled with a long period of depression and the diagnosis of bipolar was complete. He prescribed lithium, one of the best things that has happened to me in a long time, and things have been improving ever since! He calls it “the game changer”; I call it a life changer!!

I have been so impressed with Dr Katz because of his huge capacity to listen, and hear all the information then process it in a logical and helpful manner. He will then set out a considered, clinically sound plan and make everything clear and easy for me, the patient. That takes a huge lot of knowledge, skill, patience, kindness and clinical experience to attain and I think there are very few other clinicians like him. In addition, his commitment to his work amazes me. I have had appointments at 6.45pm, 8pm and 9pm!! Thank you for that!

I have a very high respect for his opinion and his directions and am just so grateful to him for being the one to really turn my life around!

So there you have it. The three most important people in my life just now, besides my husband. Three people who have left a permanent impression on my mind, and my heart really. Conditions like bipolar absolutely need to have this three pronged approach, which in the past was not such a priority but I would not give up either one of these three for anything! Each has a separate but vital role, and each one contributes in a different way to my overall mental and physical health.

I don’t think I could step into any of their shoes, even assuming I had the appropriate training. They each have some strength of character to do what they do that is beyond my understanding but its so important to me that they continue to do what they do.

I don’t know when they take holidays, I don’t know how their families cope with their dedication to their jobs but I know that without them I wouldn’t know where to go or who to turn to and I am forever grateful to them, and everyone like them who works for us, the patients.

So tell me…?

Something that I’ve found out along this journey with me, my head and I is that questions are really important.

It was that question that has become an advocate for helping others with mental health concerns that first triggered my understanding of the need for questions; R U OK?

I’ve always been interested in mental health and I saw this group pushing people to understand and use the question R U Ok? to start talking to others about what’s going on, what’s wrong, what’s troubling you, what’re your concerns? I thought it was a great idea and I bookmarked it in my head to use someday if I saw someone having a hard time.

I wasn’t sure that it would be effective but I planned to give it a go anyway; nothing ventured, nothing gained, right?

But then, before I had a chance to use it to help another person, someone asked me, and I burst into tears!! Just like that! That is how powerful the question is and how right on target it is to really hit the spot when someone is down, anxious, fearful, despairing etc.

I didn’t think it would work. But I walked into a doctor’s room to get some routine results, she asked ‘are you okay?’ and it turns out I wasn’t, to a severe degree which I had not even realised up until that moment.

When she said, ‘how are you?’, as I walked in the door I said fine. That question is just too automatic and we are too programmed into a standard response that doesn’t really give an answer. We know when we ask it that it’s more for form than for really enquiring into someone’s health. It has become a greeting more than a query. Not to say that it can’t be used as a question; some people can inject that something extra that shows that they genuinely are enquiring about your health, but usually that’s not the case.

But there is something unique, direct and unusual about the question ‘are you okay?’ that hits a nerve, that registers with a person as an actual question and that demonstrates some extra kind of care and interest on behalf of the asker.

Questions are so important in mental health.

We can’t lay open a wound, or show an obvious dislocation, or contusion, or register a positive blood culture, or low blood level as evidence of our condition.

We may not look ill, or sick, or injured to other people.

All the evidence of our ailment is locked inside our heads.

It is literally all in our minds, but not in the way that that saying is usually used, to suggest that it’s a figment of our imagination!

There is nothing imagined or exaggerated or fictitious about any mental illness.

However there is a level of difficulty for anyone treating a mental illness, be it doctors, nurses, psychiatrists, psycholgists, counsellors or any other health professionals.

To diagnose a mental illness, as with any other condition, a set of diagnostic criteria must be met. But none of those criteria are obvious when a patient walks in the door.

The diagnoser (doctor or psychiatrist) must be able to draw out the information that they need to make a diagnosis by asking questions. They need to ask a lot of questions. Questions designed to gather information, to confirm suspicions, to determine signs and symptoms of the condition.

They have to be very skilled in asking questions AND in listening to the answers for clues about what is going on with the patient.

It takes time! Sometimes a lot of time. Sometimes questions are asked over and over. There is a purpose to that; it is to gather the right information so that the right diagnosis is made and the right treatment given. It might seem repetitive but every question fills a useful part of the overall picture. It’s not a sign of incompetence on the part of the person asking the questions; its a part of their professional skill.

Patients most often don’t know what is going on with them. I’m a health professional with a clinical understanding of mental illness but I still didn’t recognise mental illness in myself. I just thought I was stressed at work. The fact that I was constantly obsessing over work all day and night, that I couldn’t sleep, that I was being clingy and petty and being a huge strain on my husband with my concerns and fears and anxiety didn’t occur to me to be an excessive reaction. So I can’t even imagine how patients with no prior knowledge of mental illness feel when they start to suffer from symptoms.

They might be scared, afraid, stressed, anxious, overwhelmed, confused, in denial or fearful of what the diagnosis will mean and what treatment will be prescribed. So the doctor also has to tread carefully around the person’s soft or sore spots but still trod and poke enough to get what they need to do their job.

In any emotional state a person has more difficulty remembering and recalling, trouble giving an accurate history, limited ability in listening and responding, and struggles with taking in information. This is one of the reasons why questions need to be repeated; to be sure that the right answer has been given. It’s also why seeing multiple doctors on different occasions can be useful in building a clearer picture of what is going on.

Often a patient may not be diagnosed immediately, because of these factors. It may be considered in the patient’s best interests to allow them time to go away and calm down, to give more thought to the history of symptoms that they have experienced, and then to bring them back and ask further questions. Of course it isn’t safe for all patients to be sent away; some need to be kept for their own safety, some need to have treatment started immediately. For those who are sent home to return late, maybe the same questions will be asked all over again, and although it seems tedious to the patient, it is all for the purpose of gathering as much information as possible so that the best outcome can be achieved for every patient.

So, questions.

Tell me what’s been going on?

How have you been feeling?

When did this start?

Who have you already seen about this?

What treatments have you tried?

Has anyone in your family experienced any mental illness?

How long have these symptoms been going on for?

How severe are your symptoms?

What symptom is the most difficult for you?

What has brought you here today?

How are you today?

Compared to then, how are you now?

What do you think has triggered these symptoms?

What has happened that might have caused this?

What do you know about your condition?

What do you know about the treatment for this condition?

What’s the worst symptom that you are experiencing?

How are you coping?

Are you experiencing any side effects?

Give me a run down on how the last week has been for you?

How often do you shower?

How often have you been getting out of the house?

Are you finding enjoyment in life?

How has your motivation been?

What have you been getting up to?

Have you been hearing or seeing things that don’t exist?

Has anyone been speaking to you through other objects?

Are you suicidal?

Have you had thoughts of harming yourself or others?

Do you have a plan to harm yourself?

Have you had suicidal thoughts?

Have you had thoughts that are frightening to you?

How has your sleep been?

Tell me what you are afraid of?

Do you ever have periods of great energy when you can achieve a lot? Or when you don’t need sleep?

When are you not anxious? Are there any places where you feel comfortable?

What things make you anxious? What things trigger a panic attack?

There sure are a lot of questions that can be asked!! And this is probably the tip of the iceberg really, these are just the questions that I can remember from the health professionals that I saw. I’m sure there are many others for other mental health disorders.

And yet, the most important question is whichever one you ask to the person that you see struggling. It really doesn’t matter what it is. It can be r u ok?, how ya doing?, what’s up with you?, how are things?, how have you been going lately?.

As long as you take the courageous step of asking and listening, you will be doing the right thing. Go you!!