Sunday, August 3, 2008

Beyond Blue: 12 Ways to Keep Going

Therese Borchard writes in Beyond Blue:

A woman who lives with chronic pain said to my mom the other day, "You can't sit around and wait for the storm to be over. You've got to learn how to dance in the rain."

That's a perfect description of living with depression, or any chronic illness. But what do you do on the days you don't think you can take the pain anymore? When you want so badly to be done with your life ... or at least be done with the suffering? What do you do when anxiety and depression have spun a web around you so thick that you're convinced you'll be trapped forever in those feelings? When you want to switch places with the 85-year-old man in front of you at church because you're thinking he'll be out of here before you, and you wonder if you do the opposite of all the advice out there on adding years to your life, if you could possibly shave off a few from yours?

We've talked about this on various threads of Group Beyond Blue. From the discussions there and on the comboxes of Beyond Blue, I've compiled a few tools for moving past that harrowing darkness, suggestions on how to emerge from a place of panic, and techniques on how to dance in the rain.

1. Escape from the pain.
Lately, when my thoughts turn to death, I've been telling myself that I don't want my life to be over ... I want a reprieve from the pain. I'm usually at a loss on how to get there. I'm tired, frustrated, desperate, so my thoughts follow the path that has already been blazed throughout the years ... and I fantasize about death, intoxication, or some other destructive behavior that doesn't require a lot of imagination.

How else can I escape ... in a positive way? Instead of romanticizing about death or inebriation from booze, I can research new kayaking routes, bike baths, hiking trails, and camping sites. I can invest the time I lose in unproductive and dangerous thoughts into planning creative outings for myself and for the family that will give me/us the reprieve that I'm craving. I can be proactive about finding sitters for the kids so that my thoughts won't revert back to "stinking thinking."


It's so bloody hard to take that first step ... to Google the state parks in Maryland that rent canoes, and to tune up my bike for a nice ride. But those are life savors. Because they afford me the positive escape that I need.

2. Track your mood. 
An essential piece of my recovery is keeping a mood journal. This helps me to identify certain patterns that emerge. As I said in my "Me on the Bad Days" post, bipolar disorder and depression can flair up seemingly out of the blue, like a thunderstorm. But often there are telltale signs that can clue me in as to why I'm feeling so fragile. You can catch these if you've been recording your mood over time.

3. Solve the problem.
I noticed, after analyzing my mood journal for the last two months, that my sleep pattern went from eight hours of consistent sleep to ten. Katherine has been climbing into bed with us, and I'm afraid of waking her in the morning. So I've been sleeping in with her and skipping my 15 minutes of meditation. But that time in the morning is a critical piece to my recovery, and if I go over nine hours of sleep too many mornings, I begin to feel depressed. I also noticed that I am most depressed on Sunday evenings and Monday mornings.

I put on my detective hat and ask myself why that is. Ah! Because I don't get a break from the kids all weekend. My reserves are used up by Sunday night or Monday morning. Also, there is inevitably more stress on the weekends, trying getting all the week's household jobs done, and less structure.

Once I could identify some possible triggers, I worked at finding a solution. I asked Eric get me up earlier in the morning, even if Katherine woke up with me. I decided we needed to hire a sitter, if only for a few hours on the weekend, to give us a small relief from the noise and chaos. And I got up early and went to church by myself on Sunday in order to squeeze a little structure and personal time into the weekend for me. Arriving at some small solutions--even if they don't solve the entire problem--made me feel like I had a little power to shift my mood from panic to peace.

4. Talk about it.
I can't get a therapy appointment round the clock, so I had better invest in some friends that won't tire of me telling them that my thoughts are turning to mush again. Actually, more dangerous than mush. They are turning to death again.


Over the weekend I called two friends and my mom. "I'm going there again," I explained. They know what THERE means ... without my having to explain or justify. I don't fully understand how gabbing heals, the scientific explanation of why venting does so much good, but I can surely attest to it, and confirm the connection between talking about something and feeling better. It's like you're a scared little kid in a lightening storm, and a neighbor, seeing that you're locked out of your house, invites you inside and makes a cup of hot chocolate for you. Well, maybe it's not that good, but it's close, which is why our phone bill is way up this month.

5. Repeat: "I WILL Get Better"!
As I said in my video, "I WILL Get Better," I think about my Aunt Gigi every time I wind up in the depression tunnel, and remember her repeating to me over the phone a few years back: "You will get better. Repeat that. You WILL get better." Peter J. Steincrohn, M.D., author of "How to Stop Killing Yourself" wrote: "Faith is a powerful antidote against illness. Keep repeating - and believing: I WILL get well. If you believe, you help your doctor and yourself." And this paragraph from William Styron's "Darkness Visible" always reassures me:

If depression had no termination, then suicide would, indeed, be the only remedy. But one need not sound the false or inspirational note to stress the truth that depression is not the soul's annihilation; men and women who have recovered from the disease--and they are countless--bear witness to what is probably its only saving grace: it is conquerable.
6. Take baby steps ... a day at a time.
On mornings that I wake up with that nauseating, knot of anxiety in my stomach, everything seems overwhelming. Getting myself to the bathroom so that I can brush my teeth feels seems like a triathlon in August. So I don't attempt the triathlon. I only have to worry about getting my left foot down on the ground. And then my right one. And then I have to stand.


I'll look at my to-do list and cross off two-thirds of it. "What on this list do I absolutely HAVE to do?" I say so myself. Everything else can wait. And then I start with the first thing, and do the first mini-movement that I need to do in order to accomplish that. If it's getting Katherine dressed, that means 1. Finding Katherine. (That's harder than it sounds.) 2. Picking out an outfit. (Ditto.) 3. Helping her out of her nightgown and into her clothes. (That's where my nervous system almost shuts down.) And so on. Each item on the list can be broken down into a dozen mini-steps.


The same approach applies with my mental anguish. If I wander into that "I just can't take it anymore" rut, I remind myself that I don't have to worry about feeling this pain two hours from now. This hour is all I have to get through. Or, if I can handle it, just one day at a time. Just a 24-hour period. As Dr. Steincrohn advised persons his patients with depression and anxiety:
Think of it this way. Just try to get through today. Take one day at a time. Tomorrow is the first day of the rest of your life. It may be the beginning of a new life, free of most of your fears and nervousness.
7. Remember your heroes.
I also remind myself that many, many people have felt like this before, and they have survived. I guess it's equivalent to a pregnant woman saying to herself, "Look, I'm not the first person to have a baby. Obviously some women survive labor pains." I think about all the mental-health heroes in my life, especially the ones, like my Aunt Gigi, that lived full, productive lives. Frank Miller, M.D., writes this in the appendix of Jane Pauley's memoir, "Skywriting":
Prognosis is good in 85 percent of [bipolar] patients, and even when treatments fail, there is an absolute trend for individual episodes of mania and depression to resolve over time. When confronted with this illness, be patient with yourself or with your afflicted family member, and whenever possible, be proactive and courageous.
8. Look backwards.
Other people's achievements can bolster your courage, and remembering your own can do the same. Beyond Blue reader Larry Parker gives himself this pep talk when he hits the panic point:
Larry, look at what you have survived. You've moved almost two dozen times in your life. You've been jobless. (Many times.) You've been (essentially) homeless. You went through a brutal divorce. You've even been hospitalized.
How does going there help Larry? Because he sees where he is today. He made it through. In his words: "Underneath my mental illness are simply enormous, even incalculable, mental reserves. And if my illness strikes again, I need to remember those reserves are there, even if I can't get to them right now."

9. Distract yourself.
Some days I'm just not worth much. All I can do is distract myself ... to keep myself from thinking about how awful I feel. Just like Fr. Joe carved figurines out of soap when he was depressed, and Priscilla made jewelry to keep her mind off of her anxiety, I will try to do anything to keep my brain occupied and away from my hurt, sort of like I did when I was in labor: baking chocolate-chip cookies, looking through old pictures, listening to Beethoven and Mozart, watching a comedy, swimming, running, biking, or hiking through the woods. (I didn't do all of that in labor, though.)

10. Get out your self-esteem file.
For the past few days I've been carrying around letters from my self-esteem file in my pocket like a baby blanket. Some people have told me that my self-esteem must be shallow if I have to rely on praise from other people. Maybe it is. But I have to start somewhere, and anyone who has sat in that panic place where you want to end it all, knows that it's virtually impossible at that time to come up with a list of your own strengths. So you have to believe what other people say. Right now I'm carrying around a comment from Beyond Blue reader Keith that says, "I've been helped so much by your selfless efforts to help us," and one from Beyond Blue reader Theresa that says, "Your winning battle to use your talent for something helpful is an inspiration." Just typing them now gives me a boost.

11. Make a list of reasons for living.
Back in December I gave Beyond Blue readers the assignment to watch the holiday classic "It's a Wonderful Life," and make their own list of why they wouldn't jump. Here's mine:
* Even though I think, when I am severely depressed, that my kids need me out of their life, I know on some other level that my suicide would scar them forever. 
* Ditto about Eric, and the last thing I want to do is to make pain for him. 
* That would be the end of Beyond Blue. And God forbid someone like Rhonda Byrne take over and tell you all just to send one big smiley face into the universe
* There's a good chance I wouldn't be successful, and would end up in greater pain than I started, maybe even crippled, and how I would be an even bigger burden to Eric at that point. 
* Taking my life would be going back on step three (of most 12-step programs): turning my will and my life over to God. 
* Any hope that I had given others through my writing and videos would be lost ... because I wouldn't have lived up to my words.
12. Pray Psalm 91.
My mom kept her bible marked to this passage most of my childhood. I'd read it over and over and over again, feeling a moment of peace in the anxiety I felt back then. I read it today, and all the psalms, when I'm in the tunnel of terror and can't let go of the fear. If I'm in a hurry, I just remember Psalm 91: 9-11:
If you make the Most High your dwelling--even the LORD, who is my refuge; Then no harm will befall you, no disaster will come near your tent. For he will command his angels concerning you to guard you in all your ways.

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