Volunteering for Mental Health Relapse Prevention

Recently I’ve taken a little bit of time out from writing about my recovery to cover what bipolar feels like to me in the posts What Does Bipolar Feel Like? Part I: Depression and Part II: Hypomania.

It’s been important to me to cover that as it allows me to share with my loved ones and give them an insight into how things feel for me. Bipolar can be a crippling disease but it’s hard for those around us to understand and we need to take some responsibility for articulating, as best as we are able, what impact it has since we can’t expect them to be mind readers I’m afraid.

I think it’s also served a purpose for this blog to provide some kind of baseline that my recovery and relapse prevention can be viewed against.

Now I want to get back to the main purpose of this blog – relapse prevention – you may remember from my post My 12 Step Design For Life that I have developed twelve ‘design principles’ that I want to live my life according to as a personal relapse prevention plan.

Well this week I did my first shift at a new volunteering role which will go some way toward both principles of ‘Meaning & Purpose’ and ‘Exercise’. I have volunteered to walk rescue dogs while they are in kennels waiting to be adopted. Providing those dogs with an escape from their kennels and some much needed love feels purposeful and rewarding. It also means that I get some pleasurable exercise out in the fresh air, not least as the kennels are a one hour return walk from the train station so I get a good few hours of walking in one morning.

I don’t feel overcommitted as you only need to commit to walking the dogs every other week although you can do more if you wish on an ‘as and when’ basis. One of my ‘issues’ according to my therapy team is that I have previously based my self-esteem on achievement; last time I volunteered a few years ago I started as a helpline listener and ended up being a Trustee on the management board. I figure I can’t really overachieve at walking dogs!

On Saturday I was paired with an enthusiastic Staffordshire Bull Terrier called Timmie who has been in the kennels for four months and I was tasked with tiring him out so he was a bit more prepared to meet his potential new parents who were coming in to see him at midday. Timmie was a beautiful dog, full of energy and playful, he’s still under training at the moment to get him out of the habit of jumping up which meant he made sure I was suitably covered in mud at the end of the session!

By midday I was feeling rosy cheeked and full of health and tired in a good way. I introduced Timmie to his potential new parents with some positive comments – fingers crossed when I go back he won’t be in his kennel anymore!

Volunteering is a great idea for those of us looking to build a relapse prevention plan; a report by the Citizen’s Advice Bureau showed that nine out of ten of their volunteers felt that volunteering had increased their sense of self esteem and purpose.

Three in four of those that identified with having a mental health condition felt that volunteering helped them to manage that condition, and four in five believed that it had had a positive impact on their health (physical or mental).

If those aren’t compelling stats to build some volunteering into your life then I don’t know what is?

And it’s not just this survey, other researchers have also found a compelling case for people with mental health conditions to invest some of their time into volunteering.

A report by the Institute of Volunteering Research found that despite some initial concerns reported by volunteers that they weren’t sure if they were capable of volunteering or would like it, almost all of the people surveyed said that it had had a positive effect on their mental health.

By contrast, almost a quarter of the same individuals said that paid employment had contributed to their mental health difficulties – so don’t be put off volunteering because of a previous bad experience with paid work.

[The survey found] that volunteering had done much to improve [the volunteer’s] mental health. Specifically, it had given structure, direction and meaning to their life, widened their social networks, improved their vocational and interpersonal skills and helped them to gain access to employment, education and training.

Institute for Volunteering Research

Researchers from the University of Exeter went further and undertook a systematic review of data from a number of trials and cohort studies and found that A that volunteers reported lower levels of depression, increased life satisfaction and enhanced well-being.

So I’ll be going back to the kennels to help Timmie and the other dogs whose only asks of me are a walk and some attention and in return I get increased self-esteem and purpose, enhanced well-being and hopefully decreased likelihood of depression. Seems like a pretty sweet deal for both of us to me!

If this article has sparked an interest in volunteering I’ll add some links on my Resources page that those of you based in the UK can use to find opportunities near you. Also, if you have an idea of what you’d like to do you might want to use Google to find out what is near you that fits – this is how I found my local rescue kennels…

Do you volunteer? What do you do?

Do you agree with the findings of the research? How does it impact your mental health, if at all?

If you don’t volunteer, is it something you’d consider as part of a relapse prevention plan?

Main image source: http://www.volunteercentres.org.uk

What Does Bipolar Feel Like? Part II: Hypomania

Last week saw the first post of this series: What Does It Feel Like To Be Bipolar? Part One: Depression …I had some lovely feedback from fellow bipolar bears on a Facebook group that it did a good job of articulating how they feel when depressed. I’ll be interested to hear whether this post also resonates and/or what the differences are for others.

It’s important to mention that I have Bipolar Disorder Type II. This means that when I go ‘high’ I go into a state that’s known as hypomania rather than full mania. Hypomania translates literally to ‘little mania’, it bears many of the same characteristics but unlike full mania does not disrupt functioning so I am still able to work and go about my life when hypomanic. It also lacks the elements of psychosis that can be found in full mania such as delusions, hallucinations or distorted beliefs such as having been ‘chosen’ for a special mission or other grandiose and delusional thoughts.

If you’d like to know more about the difference between Bipolar Type I (full mania) and Bipolar Type II (hypomania) then a good place to start is the Wikipedia article on bipolar disorder.

So here goes….as always this is my personal experience of hypomania which may differ from others so if you’re supporting someone with bipolar ask them what it feels like for them.

“How do I love thee? Let me count the ways.

I love thee to the depth and breadth and height

My soul can reach, when feeling out of sight”

Elizabeth Barrett Browning, 1850

Oh hypomania, how do I love thee? Let me count the (many) ways…

I open with Browning’s well known sonnet as I have a complex relationship with my hypomania. It’s like an unfortunate love affair. The kind of intense and ecstatic love affair that your friends (able to view it objectively) counsel you can only end in tears. It’s the equivalent of passionate, mysterious and exciting trysts with a married man. It IS going to end in tears, and they’re going to be yours. But you don’t want to stop. When the tears come, you promise yourself you’ll never go back to that man again; but when the tears end you look back at it with a bittersweet intensity and you’ll succumb to it again against your better judgement.

For those that don’t have bipolar, imagine for a moment that a new drug comes onto the market that can make people feel what I’m about to describe….sometimes I like to imagine that I’ve found a way of distilling my hypomania into a capsule and how much money I would make. Once people had tried it, they’d definitely come back for more.

Euphoria

In the early stages of hypomania I start to feel increasingly happy. I saunter around with a smile on my face. I remember things that have made me laugh and snigger to myself. I think how lucky I am, what a wonderful life I have and what great opportunities lie in front of me. I feel so very grateful for everything I have and really pity those I can see around me with scowls or frowns – can’t they see how lucky they are too?

I’m lucky to be alive. I’m lucky to have a working, healthy body and to be born in this time and in this country where I live in peace, freedom and relative comfort. How can anyone not be happy here?

You get the picture. I’m happy.

As the hypomania ramps up, so does the happiness. It notches up a level beyond most people’s experience and I feel euphoric.

Walking home at night I contemplate how everything in the world is exactly as it should be in this moment. In fact, I don’t just contemplate it. I feel it. I feel connected to the universe and that the universe is connected to me. I feel charged with energy and yet, at the same time, a sense of calm because everything is perfect. This place is perfect and beautiful. This moment is perfect and beautiful. I am perfect and beautiful.

I sigh deeply and contentedly. I put in my earphones and play high energy songs. I have a little dance as I walk along the road. Amazing.

Now…I’m not 100% sure that people who don’t have bipolar ever feel euphoric? Note to self to ask friends. If they do I assume it will be short lived and brought on by some hugely positive once-in-a-lifetime event – winning the lottery, the birth of your much wanted first child, walking down the aisle to your real, true love.

The scenario I described was me, walking down the road from the train station at night. This perfect and beautiful moment was about 10.10pm on a relatively boring Wednesday. The perfect and beautiful place was a non-descript road between a smelly recycling depot and a truck stop!

Creativity, Projects & Other ‘Great’ Ideas

I should write a book! I should start my own business even though I have no assets! I should sign up to the London Marathon even though I don’t run! I should get chickens! I should get geckos! I should get a pet ferret! I’ll walk it on a lead! I should re-model my bedroom! I should replace all of my furniture in the lounge! I should win some online competitions, I’ll enter 750 in two days! I should move house, this week! I should change jobs, right now! I should start an MBA which takes 15 hours a week even though I’ve only just recovered from severe depression and work 60 hours! I’m going to take up [insert random hobby here]! I’ll buy everything I could ever need for that hobby right now before I even know what I’m doing or if I’ll like it! I should abseil off a building for charity even though I’m scared of heights! And even though I hated it I should now skydive!

These are just some of the things I’ve done while hypomanic. Any y’know….some of them are pretty ill advised but in fairness, some of them end up sticking and making my life all the better for it.

The other thing about these ideas is I must do them NOW. I can’t wait at all. I will do whatever it takes to make my new idea a reality IMMEDIATELY.

The cupboard under my stairs is littered with the discarded remains of a million hobbies started in hypomania and abandoned soon after. I’m in two minds about how I feel about it…it’s costly and I often wish I would see things through but it makes my life interesting and varied and I love that.

There are things I’ve had to back out of when I’ve later become depressed and not willing or able to keep up commitments I made when hypomanic (my MBA, I withdrew after one month as the commitment on top of my long working hours was too much, the chickens found a new home with my parents when cleaning them out became too much to cope with during a depressive episode). Others have been abandoned once my hypomania passes (I have so many book ‘manuscripts’ and business cases that are little more than a random scattering of bullet pointed thoughts or a couple of sentences).

Productivity & Lack of Need for Sleep

When stable I’m quite a productive person. When I’m hypomanic I am a god damn Superwoman.

I am brimming with energy. I have so much of it that sleep only comes for a few hours. As I’m lying in bed my legs are jigging up and down with the excess energy. The extra hours I gain during the night when others are sleeping seem all the better to carry on with my projects, master plans and ticking things off my many checklists. I chuckle to myself thinking of all the things I can get done while these other fools get their beauty sleep.

On a hypomanic work day I’ll get up, run 5k, complete an hour’s work on the commute to the office, work for 14 hours straight churning out work like a thing possessed and then leave the office – not tired, with bags under my eyes like the overworked City boys I sit with on the tube – but buzzing with adrenaline. I have so much adrenaline I can feel it running through my veins and I’m on the brink of heart palpitations. On the train home, I can’t switch off so I work more.

You can see why people with bipolar can be high performers.

Even when I go to bed my mind is racing at an unbelievable speed. If I have a challenge that I’m facing it will race through every option open to me – how those options might play out, and further options of how others will react. I will process through these, sometimes hundreds of possible scenarios in racing thoughts until I reach a path I’m happy with.

My capacity for work is endless. It knows no limits. My brain is running at twice its usual speed and I am making connections in a split second that would take some thought in a stable mood. My memory is as sharp as a tack. I can see things very clearly and I’m not just one, but two steps ahead, of the game. My intellect is focused like a laser. I can immediately see the correct course of action in any situation.

It’s hard for me to say how much of this is, in fact, true and how much is a distorted sense of reality. I feel like a m*therf*cking shining star of performance…which leads me nicely on to grandiose thoughts….

High Self Esteem & Grandiose Thoughts

When I’m depressed my self-esteem drops to the floor. I feel worthless. What a relief it is then when my anti-depressants kick in and send me high….and I go from worthless to superstar in sixty seconds.

I feel more intelligent, more clued up and that I have more potential than anyone else I know. Everyone else seems to be thinking and moving in slow motion compared to me. They seem dull next to my sparkle. I realise this is not endearing but that’s how it is.

“Am I hypomanic or just fucking brilliant?”

Me, 2013

On top of this I feel beautiful and sexy. I’m single. When I’m depressed I felt I wasn’t good enough to find a partner, why would anyone find me attractive? Hypomanic I imagine that men must simply be intimidated by me, how could they not?

Of course, this feels great for me. I try not to let people know what I’m thinking as I’m aware that it’s not socially acceptable but I imagine aspects of it slip out now and then which must be either irritating or laughable to my friends, but if so they’ve been kind enough not to mention it.

Socialising

When hypomanic I’m a social butterfly. I’m the person that convinces the whole office to go out for drinks. I’m the one attending all the events. The person that has all of the funny stories at the pub that all start with ‘I was really drunk last night and….’. I have a diary packed full of drinks, parties and dates.

When I’m out I’ve been told I have a certain look in my eye that says ‘I’m on a mission’. I’ll line up drinks, buy myself multiple bottles of champagne. Make friends with lots of strangers. Dance for hours. When the party stops at 2am on a school night, I’ll be the one still on the dance floor being stroppy that it’s time to go home.

If I can’t find someone who wants to go out it makes me very irritable – what is wrong with these people? Can’t they see that you only live once? We’re young (actually in our thirties but who’s counting?!), we should be out partying!

If this ploy doesn’t work then I have my usual fall back plan. I put in my earphones, turn up music to full blast and dance around my living room in the dark while necking wine out of the bottle. I’ll quite happily do this until 1 or 2am. For reference, should you ever wonder, cats do not enjoy being danced with.

Sex Drive

There’s every possibility my Mum could read this post at some point so even writing the word ‘sex’ is making me cringe. As such I will go into no details, but lets just say it increases and I’ll leave you to research further as you see fit.

So….lets be honest. So far this sounds like the most brilliant illness EVER. You feel connected to the universe in euphoria, you have lots of creativity and ideas and the energy to start ten of them at once. Your productivity and mental capacity are unparalleled and you think, no, you KNOW you are the best thing to have come along in some time. You are a social hub, the life and soul of the party…and lets be honest there ain’t no party like a bipolar party!

It’s all fun and games….until it’s not.

I’m £25k in debt even though I earn good money. I’ve broken my foot, split my chin open and needed a number of stitches, detached my tendon in my finger and had a number of severe concussions where I’m probably lucky not to have suffered a more severe head injury all from excessive drinking. I’ve taken numerous unlicensed taxis home from London to Surrey (not advisable!). I’ve almost lost friends. I’ve wandered the streets of London and Manchester at 3am so drunk I probably wouldn’t know my own name countless times. I’ve had two unplanned pregnancies and subsequent abortions because of my limited ability to consider consequences and the ‘live for the moment’ attitude of my hypomania.

There are some considerable downsides to hypomania…

Loss of Self Control & Inhibitions / Risk Taking

Hypomania makes you extremely impulsive and is often characterised by a distinct lowering of inhibitions and increased risk taking. I will make snap decisions to make purchases that cost thousands of pounds with no consideration of whether I can afford them. My biggest purchase so far cost £8.5k but I’ve had a number of other purchases in the £1-5k range.

I simply do not, can not, consider the consequences when I’m like this. It would not occur to me to check my bank account. I’ve had situations where I’ve spent a great deal of money one day only to have my card declined when trying to buy milk the next day. Cue extremely hasty re-financing of debt to make it to the end of the month. The spending feels compulsive; I feel completely out of control.

It’s the same with drinking. I no longer drink for this very reason but previously I would have no limits with drinking when hypomanic. I could not consider the consequences – I would drink until I was thrown out without knowing how I would get home from London which led to some fairly expensive and some fairly awkward solutions.

Everything becomes a very extreme version of a ‘live for today’ mentality.

Racing Thoughts

I’ve touched on these already. They can be great, allowing you to process information and thoughts at incredible speed. However when your hypomania ramps up another notch they become irritating at best and a strange waste of sleep at worst. It’s exhausting to have thoughts coming so fast….and at some point they start to collide into each other as they speed up. Imagine trying to run high speed trains down a one way track where each train that starts off is 20mph faster than the last. Eventually they just start to run into each other.

At it’s worst I’ve had some experiences of racing thoughts that are simply irrational and illogical. One that springs to mind is spending two hours thinking at 180mph about street names. I can’t remember the details but I thought I’d found some kind of hidden connection in street names. It felt extremely profound at the time. Clearly, in hindsight it was nonsensical silent ravings!

 Irritability

It’s easy for the euphoria of hypomania to turn to irritability. Everyone else seems slow, dull, boring, stupid and negative in comparison to you. If they don’t want to stay out with you until 3am they must have some kind of issue. If they think you’ve had enough to drink you wonder what their problem is. Anyone who questions whether spending vast amounts of money on your latest idea is a good idea is just short-sighted and sticking their nose in where it’s not wanted. Who are they to question you? Don’t they know that your intellect and ability to process information is vastly superior to theirs?

I also find that at the end of hypomania there is always one night that starts as the usual hypomanic drinking and good spirits and then twists into the beginning of a crash and paranoia, extreme irritability and my superiority complex kick in while I’m drunk leaving me possibly THE most obnoxious drunk person ever. I have come very close to losing friendships on these nights.

The Inevitable Crash

While taking medication to prevent or calm down your hypomania isn’t always appealing in itself it’s made much more so by the understanding that after a high comes the inevitable low.

“What goes up, must come down”

English Proverb

Giving in to hypomania through non-compliance with medication is playing with fire. Are those few days or a couple of weeks of hypomania really worth the months of severe depression that follow?

It’s a poor pay off – a couple of weeks of euphoria and productivity do not balance with several months of severe depression and limited ability to function or live your day-to-day life.

Anyway….that is my experience of hypomania. How about yours?

Did I leave anything out?

Is there anything you particularly identify with or something that makes you think ‘that’s different to me’?

Main image source: natashatracy.com

Free Online Support: 7 Cups of Tea

I’ve never heard of this before but it sounds like a great support resource for those times when you just need to chat. Next time I need to speak to someone I’ll try it out and let you know what I think!

Side by Side

7 cups

I’ve been getting a few queries lately about where to turn for support during difficult times. The answer, of course, depends on the severity of your situation. If it’s an immediate crisis, please contact a crisis center in your area. If the situation is less urgent and you just need somewhere to vent, 7 Cups of Tea is a great place to do that. They provide free online support to anyone and everyone, anywhere in the world. You can select a trained active listener at random or select a specific one that you’ve worked with before. All conversations are confidential. Although the site is an excellent resource, I’d always recommend reaching out to a friend or a loved one, if possible. If your situation persists, I’d highly recommend seeking long-term support through a Counsellor or a Psychiatrist. Feel free to contact me by email if you’d like some recommendations.

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Work/Life Balance: Returning to Work After Depression

When I returned to work after my first time off with depression last year I was very keen to get back to being ‘normal’ as soon as possible. My main focus was on getting back up to speed in my workplace and proving to my employers, colleagues and most importantly myself that having bipolar disorder didn’t need to change anything.

My psychiatrist was clear that I needed to complete a phased return to work and I followed his advice. I left the psychiatric hospital on a Friday and had my first day back at work the following Wednesday. I then increased my number of days until I was back at work full time after one month.

Work was extremely important to me and being a top performer underpinned my self esteem more than I wanted to let on. I made it very clear to my manager that I fully expected I’d be able to do my role, with no alterations, and that I remained as ambitious as ever for progression and hoped that my time off wouldn’t be held against me in this regard.

Initially my return to work went well, but soon my mood dipped and I went back into depression, albeit less severe, for a further three months before recovering fully.

Fast forward eight months and I was signed off work with severe depression again.

So what went wrong?

There were a few triggers and causes for my relapse but without a doubt a major one was my attitude to work. In hindsight having based my self esteem largely on work I was clearly in denial about the impact of having a severe mental illness that appeared to be worsening over time and my need to manage my workload and stress to prevent a relapse.

I simply saw my first full breakdown as a ‘one off’. I’d worked without a breakdown for ten years so surely I’d now do at least another ten?

This time I’m not in denial. I have a mental illness and it needs to be properly managed. This means that I have had to make a decision to request alterations at work.

This may sound like a straightforward decision but it took me a fair amount of therapy to get there as work was my life, I’ll probably cover this off in a future post as I want to focus on return to work plans here.

So, decision made….I can’t continue to do my role in exactly the same way….where do I go from here?

The Equality Act

Being a closet nerd I immediately turned to Google to understand what my rights were and where I stood legally with my employers.

I was pleasantly surprised to find out that I was highly likely to be covered by The Equality Act, 2010 (I’m based in the UK).

A mental health condition is considered a disability if it has a long-term effect on your normal day-to-day activity. This is defined under the Equality Act 2010.

Your condition is ‘long term’ if it lasts, or is likely to last, 12 months.

‘Normal day-to-day activity’ is defined as something you do regularly in a normal day. For example – using a computer, working set times or interacting with people. If your mental health condition means you are disabled you can get support at work from your employer.

There are many different types of mental health condition which can lead to a disability, including dementia, depression, bipolar disorder, obsessive compulsive disorder, schizophrenia and self-harm.

Source: www.gov.uk

It isn’t completely clear cut as you have to show that bipolar disorder impacts your normal day-to-day activity; I carried out further research and found that the impact it has on my memory, concentration, anxiety levels and ability to carry out normal tasks due to lack of motivation and hypersomnia means that I would almost certainly be considered disabled under the Act.

This is important as it means that my employers have a duty of care to make ‘reasonable adjustments’ for my illness.

What Are Reasonable Adjustments?

If you are considered to have a disability then your employer is required to provide support to you in the form of ‘reasonable adjustments’.

Employers must make ‘reasonable adjustments’; in other words take reasonable steps to change work environments or arrangements that put a disabled person at a substantial disadvantage.

Source: http://www.mind.org.uk

The important thing with reasonable adjustments is to sit down and really think about what would help you manage your mental illness at work. It’s likely to be different for everyone.

Some questions to consider are:

  • Are there specific tasks or activities that are a trigger for you at work?
  • What are your working hours or shifts like? Does this impact your mental health?
  • Are there any factors in your working environment that cause you stress?
  • Do you need time off to attend medical appointments or therapy/counselling to manage your illness?
  • Do you need a phased return to work over a period of time?
  • Is your workload a trigger or perhaps specific deadlines?

This should give you some ideas of what triggers your illness at work and therefore what adjustments you could propose to your employer to help you with these.

It’s important to remember that the adjustments that you ask for must be reasonable. I’d love to ask my employer to pay me the same money for working 1-4pm each day but I don’t think I’d get away with calling that reasonable (I can only dream)!

Phased Return to Work

One of the most common reasonable adjustments to request after being off work with a mental illness is a phased return to work. If you’ve been off work for a number of weeks it’s likely that going back full time immediately will put you under a fair amount of stress and pressure. Having a phased return allows you to build up your hours at work over a period of time.

This time I proposed a phased return to work plan that gave me a couple of weeks off after being in hospital to give myself some time to get used to day-to-day activities and chores before dealing with work pressures. I’ve also taken more time to get up to my full hours as I felt that I went back too quickly last time and that’s why I slipped back into a moderate depression.

My return to work plan is:

Week 0: Leave psychiatric hospital on the Friday

Weeks 1-2: No work, get used to being at home, doing chores, etc

Week 3: One day at work

Weeks 4-5: Two days per week at work

Week 6: Three days at work

Weeks 7-8: Four days per week at work

Week 9: Full time

One thing I would highly recommend is that you have your psychiatrist (or at least your GP) review and agree your phased return to work and that they note this schedule on your Fit Note (sick note).

This adds considerable weight to your proposal and you are much more likely to find that your employer is amenable to a phased return to work if it comes across as having been proposed by a medical professional.

Other Reasonable Adjustments

After considering my own situation and triggers I’ve requested a number of other reasonable adjustments.

Working from home: I have a fairly long commute to and from work so I’ve asked to work from home two days a week to cut this down and give me more time to do activities outside of work which will help me to manage my stress levels

Adjustments to travelling times: I often have to travel to offices across Europe and previously used to get up at 3 – 4am and get home at 11pm when travelling. Regular sleeping patterns are very important in managing bipolar disorder so I have requested that when travelling for work I do so in times that mean I don’t get up earlier than 6am or get to bed later than 10pm

Focusing on my core role: I have a tendency to take on more and more work, well beyond my core role. I do this when I’m stable and I’m even worse when I’m hypomanic. Then, when I get low I freak out about how much work I’ve got to do and the stress of this is my main trigger. I’ve requested to have a mentor at work who meets with me regularly to discuss my workload and that I don’t take on any work outside my core role without my mentor challenging this. My aim is to only do my core role and so reduce my working hours drastically from getting home at 9 or 10pm to getting home at 7 or 8pm at the latest.

So those are the adjustments I’ve put forward, my phased return to work has been accepted and I’m just waiting to hear about the rest.

Have you ever asked for adjustments at work related to a mental illness? How were they received by your employer?

What are your work related triggers and what do you think could be put in place to help you manage your illness?

Exercise & Goals….London (Marathon) Calling!

Image Source: The Telegraph

I’ve found that creating my plan for bringing happiness back into my life has created a temporary uplift in my mood just by giving me moments of hope that things can change. It’s a nice contrast to my previous nihilistic feelings though I seem to waver between the two thoughout the day which is fairly confusing for me and probably more so for people around me. Like the old bipolar joke they don’t know whether they’ll get an answer from Tigger (I’m so excited about all of my plans! Listen to me talk about them for hours!) or Eeyore (I can’t imagine ever being happy. My life is pointless).

Time to put some of these plans into action and build on the momentum……cue a very timely voicemail.

To set the scene…it’s a Friday in October, I’m sitting on a sofa in the small in-patients lounge of the private psychiatric hospital I’m staying at waiting for my discharge meeting. A few of the other in-patients are with me having a cup of tea and some idle chat since we’ve finished our last therapy session of the day.

While I’ve been with them over the past three weeks I’ve had a few questions about what it’s like to be hypomanic since I’m the only bipolar in the hospital; among other descriptions I’d used an amusing anecdote about the last time I was hypomanic in April when I entered the ballot for a place in the London Marathon even though I can’t run to the end of the road. Cue amused chuckles.

Anyway, back to Friday in the lounge. I’m sure you can already guess what the voicemail is…..”Hi Sarah, this is Natalie* from the London Marathon team, first of all I just want to congratulate you on being successful on getting a place in our 2015 Marathon!…..”.

I didn’t hear the rest of the message as I cut the message short in sheer horror. In the manner of Laurel and Hardy I thought ‘well, this is another fine mess I’ve got myself into’.

Always ready to use my own misfortune for a laugh I announced the content of the voicemail to the others to much hilarity. Once they stopped laughing, which took a good ten minutes, Jarrod* one of the other ‘in-mates’ suggested that I give it a try. Not likely I thought…as soon as Monday comes around I’ll give the marathon team a call and withdraw.

Over the weekend though my thoughts kept turning over the possibility of actually aiming to complete a marathon. There seemed to me to be something poetic about having signed up to complete this ridiculous (for me) challenge while manic and hearing about being successful on the very day I was leaving hospital to start changing my life. How fitting it would be to have this very specific and visible challenge as a representation of the more personal challenge of changing my life.

So it was decided…..the exercise I will be building into my routine is running…and more specifically training from couch to marathon in six months!

I’ll post my training plans in a future post as well as progress updates and how having goals and regular exercise benefit those of us with mental health issues. I will be running the marathon in aid of Mind, a mental health charity in the UK (www.mind.org.uk).

Any tips from runners would be most appreciated!

My 12 Step Design for Life

I’ve taken longer to write my next blog post than I anticipated as I’ve been focused on recovery to the exclusion of writing about recovery. In some senses this means I’m now playing catch up in this blog. I’ve been forging ahead with my plan in real life and things are starting to progress at pace; hopefully with a few regular blog posts this week I can bring this blog up to speed.

In my last post I touched on defining happiness to take it from a noble but very vague objective to something a little more concrete that seems achievable. In this post I want to focus on the overall elements or steps of the plan I’m putting together to seek out this elusive happiness in my life.

My personal motto hangs upon the wall next to my bed on a sign that says “Some people want things to happen, some people wish things would happen, others make it happen”. Some might think I’m being too contrived but I believe that I can make happiness happen!

The twelve steps of the design for my new life are listed below; there’s plenty of research and interesting ‘lightbulb’ moments that sit behind each one; I’ll save that for future posts. The twelve steps are:

  1. Connections – Developing meaningful connections and relationships with other people: friends, family, work colleagues and in the community
  2. Meaning & Purpose – Finding something (or multiple things!) in my life that feels meaningful to me
  3. Exercise – Introducing regular exercise into my routine
  4. Sleep – Regulating sleep patterns which according to research are particularly important in managing bipolar disorder
  5. Creating Positive Experiences – Building positive and pleasurable experiences into my life and taking the time to cherish these
  6. Meditation & Mindfulness – Making time for relaxation and learning to focus on the present
  7. Creative Outlet – Finding a creative outlet to teach myself to enjoy something without reliance on ‘achievement
  8. Healthy Eating – Eating a healthy and balanced diet to manage my weight and help to regulate my moods
  9. Self-Care – Taking care of my self and my home to create a positive and nurturing environment
  10. Goals – Defining some challenging but realistic (non-work) goals to work towards to give me a sense of having a positive future ahead of me
  11. Work/Life Balance – Finding a more successful balance between work and life in order to have the time to broaden my life outside of work and to reduce my reliance on achievement at work for my self-esteem
  12. Medication – For me personally I would not be able to regulate my moods through my own actions alone and so ongoing medication is a key element to relapse prevention which underpins all of the other elements of my plan.

These are not resolutions. I’m not making them with a half-arsed vague desire to stick to them for a few weeks. I am genuinely setting out to re-design my life around these elements.

I think most of them are common sense but how many of us can say that we feel we really live by them and incorporate them into our daily life? I certainly haven’t been.

What do you think of these twelve steps? What would you add or change for your own design for life?

What do you think of these twelve steps? What would you add or change for your own design for life?

Happiness….Right…Ummm, What Is That?

The other day I sat down to start thinking about my plan to change my life to increase my happiness.

I hit a slight snag.

I realised that I didn’t know what happiness is. As always I relied on Google to provide me with an answer to any given situation in life; Google told me that happiness is “the act of being happy”. Thanks Google.

Wikipedia turned out not to be much more help, it said that happiness is “a mental or emotional state of well being characterised by positive or pleasant emotions ranging from contentment to intense joy….Happiness is a fuzzy concept and can mean different things to different people”. This left me not much wiser.

I’m sure many people would be comfortable launching into a pursuit of happiness with the view that they’ll know it when they see (feel) it. I’m not one of them. I just felt I couldn’t commit myself until I’d found a definition that made sense to me and that I could work from.

I could have developed my own definition but I much preferred the idea of stealing one that’s ready made! So off I (digitally) trotted to Amazon to download several books on happiness and positive psychology. The books ranged from theories developed from impressive sounding quantitative studies through to personal accounts of people seeking to inject happiness into their own lives.

After my reading was finished I found a definition that had stuck with me.

“Happiness is experiences of purpose and pleasure over time”

I’m a big fan of good old common sense and this definition passes the common sense test for me. I expect that those more artistic or spiritual than me may find this definition lacking in sentiment. I have the same amount of sentiment as the average house brick so it suits me just fine!

The concept is that we should fill our time with activities that give us pleasure or purpose (or a combination of both) ensuring that there is a good balance between the two.

Measuring my current life against this I can see that Monday to Friday is almost exclusively purpose (work) leaving me feeling drained. At the weekend I then fall into an exhausted heap and spend it mostly indulging in whatever is on Netflix, this can be pleasurable but has no purpose at all. The net result for me is that I’m left feeling that my life outside of work is pointless. You don’t need me to tell you that this is not a good foundation on which to build resilience to mental illness!

Through the reading I also decided I should use a measure of how my happiness develops over time. I’ve decided to use the question ‘Overall, how happy are you with your life on a scale of 0 to 10?’.

There are some downsides to using this measurement – for example the score given has been found to be influenced by the last activity someone was doing. You’re much more likely to give a higher score if you’ve just been having a great time than if you’ve just finished your chores! I’ll try to be conscious of these influences when I answer the question. The upside is that it provides a very simple indication of trends which is good for my purposes.

Asked two weeks ago I would have scored a 2. Today this has already increased to a 4 through therapy and medication. I’m looking forward to seeing where I can move this to.

How do you define happiness? How would you rate your overall happiness today?

Starting the Journey

I’m writing this post from my ‘safe place’, a private psychiatric hospital set in the Surrey countryside (courtesy of my private medical insurance). I stayed here after my breakdown last year and so immediately knew that I wanted to return here after my recent relapse.

After a few weeks here of steadily increasing medication and a full schedule of group therapy I am still struggling with my depression. I have, however, at least got to the point that I now consider myself ‘in recovery’.

How do I know that I’m in recovery? Simply put, I can see a point in continuing to live. I don’t yet feel like this all day, every day but enough to believe that I have a future and with enough hope and optimism to consider making plans to shape this future. This is a significant difference to my thoughts a couple of weeks ago.

During my therapy it has become clear that one of the reasons I have relapsed is because I take on too much at work and place myself under too much pressure to deliver that work perfectly. I’ve come to learn that I base my self-esteem almost exclusively on achievement at work. As a consequence of this my life has narrowed in scope over the years until work makes up the majority of my time and takes the majority of my attention.

It’s little wonder then that when I’m depressed my thoughts turn to my life as being pointless. I feel of little value and worth and that losing my life would ultimately be no worse than squashing a worker ant since I feel that my life doesn’t have any more meaning than that.

Now that I’m taking my first tentative steps into recovery I have accepted that I need to re-design my life to introduce happiness and build my self-esteem on more solid ground. As far as possible I want to protect myself from another relapse.

I have made a decision to make manageable changes to my life in order to:
– Decrease the likelihood of a relapse through the use of accepted relapse prevention techniques such as self-care, exercise and reducing triggers
– Increase the level of happiness in my life as I believe this will make me more resilient.

In essence I hope to achieve the psychological equivalent of building up my immunity system. As someone with bipolar I have to accept that relapses are possible even with medication. If I don’t have an effective relapse prevention plan I’m playing Russian roulette with my mental health, and ultimately my life.

Do you have a relapse prevention plan for your mental health illness? What do you swear by to keep yourself safe and happy?

In Pursuit of Happiness…

One year ago I had to admit that I could no longer carry on.

You see, I’ve suffered from depression many times before but I’d always been able to scrape by. Sometimes I would only just be functioning but only just was good enough.

Last year was different. In addition to the usual debilitating depression came crippling anxiety; a tag team of hopelessness and despair. I could no longer hold things together and so, instead, I fell apart.

Finally, after twenty years of suffering, I sought help not long after my 31st birthday. This was not the start of my 30’s I had anticipated. I was diagnosed with bipolar disorder, a diagnosis that has, and continues to, change my life.

My intention is to use this blog to explore and articulate my thoughts and feelings about living with bipolar disorder as well as raise awareness of mental health issues, particularly depression and bipolar disorder. Its main purpose though is to keep me focused on my attempts to find a way back to happiness after my recent relapse….I’m a bipolar in pursuit of happiness.