Self-Care and Chaos

Posted by fxckfeelings on July 12, 2018

After experiencing something painful and difficult, it’s natural to work hard to regain control and find ways to avoid going through the same thing again. In some cases, that means avoiding a certain kind of person, or type of dark street, or a specific hairstylist, and hoping that these better choices, combined with better luck, will keep you safe. However, when the experience involves a severe episode of what could likely become a chronic mental illness, your smart choices and allotment of good luck are fairly limited; as much as you may want to prevent a recurrence of your disease and future symptoms, no search for the best treatment or routine is guaranteed to help. And pushing yourself too hard to keep yourself safe won’t just dangerously raise your expectations but distract you from the real work of making a plan for how to deal with a relapse. So real hope should never create expectations of control, be it over your safety, heart, or bangs, but on living one’s life as fully as possible when control isn’t possible.
-Dr. Lastname

I am a person who has a mental illness! I have treatment-resistant depression and ADD and a soupçon of PTSD. I am in treatment with a psychiatrist I like very much and it’s actually pretty chill that therapy really works. I’m a much healthier person than I was five years ago! So between that and the fact that I have been in therapy long enough to throw my inner child a quinceañera, I am not asking for treatment-related advice. It’s just that sometimes, daily life is really challenging, and as a moderately successful person with a moderately growing career, I spend a lot of time worrying that my relative instability is going to just tank everything. Like I have spent the past three days in a panicky fear that I had re-entered the depression abyss when it turned out to really just be hideous PMS, which I can’t predict (really). Either way, my Depressed Self was back in action and I spent a couple days sleeping, crying, and unable to work. My goal is to build a routine, consistent life with steady work and self-care, despite the occasional, disruptive curveballs that depression throws my way.

F*ck PTSD: The F*ck Feelings Guide for Individuals and Support Groups

As the old saying goes, if you want to make God laugh, make a plan. If you’re a person with a mental illness, an addiction, or just a need to eat less saturated fats, and you want to control your issues by building a routine, consistent life with steady work and self-care, then you won’t only make god laugh, you’ll also drive yourself nuts.

The urge to find order through routine is a reasonable wish, but you don’t really control the outcomes of life in general, and certainly not when you have a chronic disease (or addiction, or habit) that can recur whenever it wants to, even when you stick to a smart treatment plan and take every known measure to keep it in check.

Never make yourself responsible for what you don’t control. What you’re saying, and shouldn’t, is that you should be able to figure out how to be lucky. Unfortunately, when your luck runs out, you’ll think your huge efforts have failed and get depressed and give up. That’s why making a big plan to reach your goal is a bad idea, while taking it one day at a time isn’t.

A better approach is to try to build a routine, consistent life whenever you can, even when symptoms recur and are hard to bear. That’s a tough goal, but it’s measured by daily effort, not overall outcome, so success is possible and on a reasonable scale. The results won’t always necessarily make you happy, but you’d only make happiness your goal if you wanted to delight your chosen deity and destroy your sanity at the same time.

As for the panicky fear that you experienced during your brief relapse, remember that depression and anxiety tend to distort rational thought; they tell you the worst is sure to happen, nothing is working, and that you’re helpless and going to lose everything. That’s why one of the major goals of depression is to prepare yourself for such negative thoughts, recognize the ways in which they lie, and train your rational mind how to deny said thoughts and keep them from taking over.

So, instead of trying to prevent momentary lapses via wellness and routine, accept that they may happen and focus on the ways you and your brain can prevent major fallout when they do. When the panic starts up, remind yourself that, no matter how bad you may feel or how bad things may get, you recovered before and that, while recovery usually occurs in time, you get there one day, task, and thought at a time. Remember that there are many treatments you haven’t yet tried, and that you’ve been able to maintain most of your life activities and relationships in spite of symptoms. Become familiar with the criteria for medical leave and other employment benefits so you won’t panic if your symptoms threaten your ability to work.

You’ve already figured out how to build a routine, consistent life; so you just need to develop a routine disaster plan. Remind yourself that you also know a thing or two about responding to pain, distorted thoughts, and disability while planning (ha!) to preserve as much of your normal life as possible.

STATEMENT:
“Being well-educated about my depression means I’m not surprised by relapse or the panic that goes with it, and I have a number of plans for dealing with it. I can never prevent depression from recurring, but I am knowledgeable about symptoms and treatment and know how to manage an illness well while using all my strength to stay independent and be a good person.”