This is a blog about depression. If you are easily offended or take offence to my very sarcastic humour, please do not read any further. Mental illness is not a joke; it is not something to point fun at and I fully understand that. BUT…when the going gets tough, sarcasm and humour is my defence and so I will be parading it around all over this blog.
If you need help, please get it. Whilst I hope this has a happy ending, I don’t know yet and given I’ve not been able to fix myself, I really don’t want others using this as a ‘How To Be Happy for Beginners v2.0’
I slept! And woke up! And in time for Breakfast! WINNING. Right, let’s see how brave I am really feeling… can I ask for an omelette?… No! Ok, what about asking for toast? YES! I am counting this as a WIN! Two slices of toast and marmalade plus alpen. This is progress. I am one step closer to omelette heaven. Not only do I ask for toast, I sit with Patient S and talk. Bravo me.
Following my attempt to ask to go out yesterday, I am determined I’ll actually ask today. I’ve written a shopping list! Got to love a list. It makes tasks that bit more satisfying as there is something to cross off once it’s done. The key to a successful list is to put something down that is quick and easy to complete so the momentum starts. My easy win on this list, sparkling water.
PyschoEducation first though and today’s session is a depression & Anxiety workshop. I missed it last Monday as I was in ‘hide under the duvet’ mode so I am going to make it today. We focus on depression and this is a session with handouts and homework. We run through how it’s easy to become trapped in a depressed cycle. Something that might surprise some is that depression has physical symptoms too. I don’t only mean my smelly breath and greasy hair but also weight loss/gain; stress acne; skin irritations and hair loss to name a few. The consequence of the negative thinking and physical symptoms is people tend to then have reduced activity. Yes, as we know, I did spend the weekend prior to being admitted sat on my sofa and cancelling plans. The reduced activity leads to a loss of pleasure and achievement. Check that, I did not feel pleasure or achievement by sitting with my blinds drawn for the entirety of the weekend. Reduced activity also increases one’s negative view of themselves. Negative thinking and physical symptoms also lead to reduced problem solving. Yup, I pretty much freak out when something requires any analysis. This increases hopelessness which continues to fuel the depressed mood. This all makes complete sense to me. I have been shutting myself away, hiding from the world and things I need to get done but then feeling thoroughly shit about myself for not doing anything.
Having identified the cycle that I am trapped in, I need to understand how to break it. As ever, there is no magic wand to fix me or pill to change this. Instead, I need to find activities that make me feel good and I enjoy. I should start a bad day with something that makes me feel better about myself. Start small, and work upwards. This all makes sense, I just wonder how easily applicable this is in the outside world. Let’s start really small, let’s keep wearing matching underwear. This may sound silly to some but wearing matching underwear is a bit like having an invisible superhero cape. I makes me feel instantly stronger. Not sure my rambling makes sense but I know what I mean. Moving on from my underwear! I should also paint my toe nails. There is something so gratifying about having polished nails.
We start making lists of activities, however big or small, we can call on to help us feel worthier. Basically, this session boils down to not saying ‘yes, but…’ and the well-known song:
‘When the going gets tough, the tough get going’
Start with a small activity to build momentum. That’s the second time I’ve used momentum in one day. If I can turn my over the top list making skills into an activity list, maybe I can crack this. We are reminded to keep asking ourselves:
- Who am I doing this for?
- Do I have any resistance to doing this?
- Do I really enjoy it?
I am going to need to start experimenting with what I enjoy. In a work conference last year, we focussed on resilience and what we enjoy. I remember feeling mortified as I didn’t have something to say to my table. I couldn’t think of one thing that I do because I enjoy it. So, I lied. That was in November and I went home thinking this is getting too much for me. Why didn’t I speak out then? Why didn’t I stop the depressed cycle perpetuating itself? If only I’d asked for help. It turns out that when I did start communicating, everyone was incredible towards me. I never thought they would be. I was also lying to myself as I couldn’t face up to it.
After the first session, I feel drained, tired and frustrated at myself. Self-hatred is a common theme for me. I genuinely do hate everything about myself. It’s exhausting. If you don’t hate yourself, don’t start! Also, reach out to me to tell me how you manage to like yourself please. I’m chasing that elusive magic answer.
As we know though, group sessions stop for no one’s depression and onto CBT it is. We are an all female group this morning and it feels like a safe group. By which I mean, speaking won’t be quite so scary. We all talk and to be honest, it’s a bit more like an IPT session than a CBT session. It never fails to astonish me when another patient says something that I have been thinking or feeling. I am less of a freak than I thought I was. The therapist explains that we all have a pain in our heart but instead of focusing on it, we focus on external things like work; food; drinking; drugs; cleaning; list making; wearing matching underwear 365 days of the year. These external things give us something to focus on. At some point the external focus will fail and we break as we can’t cope with the pain in our hearts. We form an attachment to these external things but the attachment is only perceived safety when in fact we are hurting ourselves. The deeper the pain, the more we self-sabotage. I’m screwed then!
The answer to healing my pain I hear you ask? Find coping strategies. Ok, this will be tough, my coping strategies to date haven’t been good for me. What I need to do is slowly but surely change the messages in my head. Stop telling myself I am a fat failure, that I am not good enough, that I don’t deserve friends or relationships, that I am worthless. Mmm, this will be interesting as I’ve been telling myself these messages for a long time. I’d go as far as saying I’ve been telling myself this for more than 20 years. Hands up who wants to swap brains with me please? Any one? No? Ok, looks like I’ll have to do this the hard way. I should stop looking for evidence to support my internal messages, it’s a message which is not on my side. According to an article in The Daily Mail (yes, I know, a truly stand up, to be trusted, news source!), people can change their personalities. Well, phew, that’s a relief to know.
As a group of females, we can’t help but veer onto the topic of food and weight. Patient L explains she’s still bulimic but hasn’t told anyone here. She’s not sure if she should ask for help. Time for me to offer some support. My view point on this is, if you are not ready to let it go, there is no amount of help that will get you out the other side. When I was making myself sick, I got help. I paid for it myself. I wasn’t 100% ready to let it go though. Being sick was euphoric and a real buzz. It was also painful and revolting. She could move to the eating disorder unit but it won’t fix her if she’s not ready. All it will do it pause it. For me, it took really wanting to give it up to be able to actually stop. Although I’ve had the urge, I’ve somehow managed to keep it as just that, an urge. I hope that helps a little Patient L.
Lunch next and as I am heading to the restaurant, Patient A2 pops up from nowhere. Oh, my days, seriously how are you tracking me down like this? I lie, again. I tell her I am tired so getting my food to go. I really can’t face her questions. I know she means well and I know she’s suffering too, but I can’t fix everyone. A quick pit stop via the restaurant and I am becoming even braver. I don’t like the 2 hot mains on offer so I only go and ask for a ham and cheese panini. Look at me go! I’m at serious risk of having an omelette at this rate (I know, you’ve read that before but maybe it’s true this time?).
Back in my room and my bubble bursts. I am not a low enough risk to myself to be allowed out alone. I’d have to be accompanied. Insurance doesn’t pay for 1:1 nursing, it’s £41/ hr. Any they come with you in their uniforms. No, not for me. My very lovely list of shopping is going to have to come to me via visitors. Damn it. On the plus side, the panini is really good.
1400 rolls around far too quickly and it’s time for IPT. We start the check in’s and I am the last in the circle. Everyone before me has said they don’t have anything to bring to group or they only want to listen. The spotlight is well and truly on me as a result. I start talking, talking about things I didn’t even realise upset me. Then, yes, you guessed it, ugly snotty tear crying starts. Shit! The one time there are no tissues in the therapy room. I mean come on therapist, that’s a rooky mistake for a psychiatric hospital. I can’t stop the crying, it’s literally taking over as my whole-body shudders, and there are no tissues… my jumper is not as absorbent as I thought. The group are brilliant. They don’t laugh, they don’t mock or belittle me. They chime in to say they agree or how they have coped with it. You guys are legends, thank you. An interesting point is that of responsibility. I incorrectly take on responsibility that is not mine to worry about. An example is evident in IPT. I am frantically apologising for the snot, tears, damp sleeve and taking up all the time when the therapist intervenes. He explains it’s his responsibility as the therapist to shut the conversation down if it was taking too much time, upsetting anyone else or if the group didn’t appear to be ‘going with it’. My responsibility in therapy is only to look after myself. He has allowed my snotty teary rant to continue as, had I looked up, the others were nodding their head in agreement with what I was saying.
My take aways from the session is:
- I need to assert boundaries in some of my relationships
- I need to identify what’s my responsibility and what’s theirs
- Start with small things I think I like and slowly I’ll identify what I truly like vs. what I thought I liked as it makes others happy
The therapist ends with a metaphor. I like metaphors so this should be good. We need to treat ourselves like the adult on the airplane which is crashing. We need to put our own oxygen masks on first before we help others. We are no good to others if we can’t breathe.
We check out and my head feels like spaghetti junction. I can’t face Chi Kung today. I know I said I’d do all 4 sessions but (let’s put some of this self-care into practise) I need a break and that is ok (Hallelujah!). Instead, I finish my colouring from yesterday. Ok, I may have gone outside some of the lines, ok, the colours aren’t all perfect and matching. BUT, that is ok as I have enjoyed doing it and it helped me destress and process. Wow, I really am learning.
Dinner is vegetable ratatouille in filo parcels with the never ending steamed veg. Pudding is an apple muller rice which I have back in my room. I’m tired and stuffed and would really like to have some down time before my friend arrives.
Whilst doing Sudoku, I realise my anxiety is rising. Why? My friend is going to be a little later than she thought so she might be here when my psychiatrist does her ward round. Patient C, you are being ridiculous. Tell Friend BS this may happen. She’ll understand. (Un)surprisingly, she does understand. She also asks what she can bring. Bingo, this is my chance to get some things on my shopping list.
BS arrives and it’s lovely to catch up with her. It’s lovely how much she cares. Take it Patient C, sit and take it. Sit with it, sit with it. We talk about my lovely snotty crying episode and she comes up with an idea, I need to do a RACI (responsible, accountable, consult, inform) matrix for my relationships! This is a great idea, thank you Friend BS. Thanks also for the tangfastic, that’s as valuable to me as the RACI idea.
The psychiatrist comes and there is no issue with Friend BS being here, she goes and gets herself a drink whilst I talk to Dr. E. The talk with Dr. E is a bit of a blow. It looks like I am going to be here for a while longer. This is a mixed blessing as on one hand it takes the pressure off needing to get all sessions ‘perfect’ as I have time on my side, on the other side, it’s heart breaking. Being in hospital, even a plush private hospital with questionable carpet room, is hard. Really hard. Friend BS goes and I get into bed. Tonight’s movie of choice is Tim Burton’s Charlie and the Chocolate Factory. Final question of the day, do calories consumed in your dream count?