What would help? What can we do?

Sadly over the past week I have become hugely anxious and paranoid and this is really starting to affect me a lot and is very debilitating. 

I have been so well for a long time and whilst I know it was unlikely to last for ever I am terrified that this anxiety might lead to an episode of depression and/or hypomania. 

I have already been to the doctors and started to put good support in place which has led to a medication increase which is helping with some of the symptoms.

I have also had so many offers of support and help and I am so grateful for these but I sometimes worry that I can’t always tell people what would be helpful or if there is something specific they can do. Sometimes the very simple things like a text or a chat over a cup of tea are enormously helpful and it is those spontaneous gestures that seem to have the greatest effect for me in combating the paranoia and very low self esteem.  I worry that people will think I am mucking people about or being a bit difficult when I don’t know what might help or what someone could do for me. 

In fact at this precise moment I am actually unsure what I really need or what could help as I am either still in a bit of denial that I feel unwell or just fighting all the thoughts going round my head so much that nothing makes much sense.

So to all those amazing people that try daily to help me and countless others with a mental illness – thank you. Please stick with us and apologies that sometimes I might appear vague about what would help the most, I am hugely grateful and just by being there you are helping so much.

Where have I been?…

So after a long break from Twitter and from my blog I am back! 

There are lots of reasons why I decided to have a break but I think I made the right decision and I am proud of myself for making a few changes (both on and off line) that I hope will keep me well for longer and also help me to see the positives that I am experiencing as well.

Twitter is an amazing source of support, however I got a bit worried a month or so ago that it might of been fuelling my paranoia.  I don’t for one minute think that it was the sole cause but it was something that I was aware of and therefore that I could quite easily do something about. Other aspects of my paranoia aren’t always so easy to sort.

I also found myself getting quite upset about stigma on Twitter.  I started to take personally stigmatising comments and at times became anxious when I read certain tweets.  This wasn’t healthy and so therefore a break enabled me to realise that I couldn’t solve the problem myself and eradicate mental health stigma.  It also helped me to realise that I can do just as much in my life at Church, at work and within my own circle of friends and family to start changing the way people view mental health without challenging every reference on Twitter.  

I have also been incredibly busy (with very positive things) and I am slowly getting used to the fact that I am not 100% well but that is ok (ish). I have started swimming and eating much more healthily which is also having a positive impact on my life. I am still having the occasional day when I resent being ‘not quite well’ – where the anxiety prevents me from doing what I really want to do or the sleepness nights trigger a negative spiral of thoughts and I feel that I am going to become very unwell and therefore walk on eggshells for the next few days.

I am pretty realistic about the fact that I will be unwell again in the future but the period since my last serious depressive episode has been different. I am acknowledging my vulnerability but staying more positive than before. I am coping and whilst some days are better than others I am moving in the right direction.

Thanks for sticking with me! 

Revisiting my #WRAP 

I have wanted to revisit my Wellness Recovery Action Plan (WRAP) for a while but as I have spent the best part of the last 2 months being quite unwell it wasn’t really a good time. I wonder if now is even too soon as I have only had 4 better days and maybe it is too early to look at how I can do my best to stay well in the future but I feel I need to do this.  

I use a fairly standard WRAP format and one which I have worked hard with my GP to put together. This WRAP includes both depressive and hypomanic symptoms due to my Bipolar diagnosis.

To start with I looked at my ‘Wellness Tools’ (Activities I enjoy or that help me feel better) which include:

Spending time with husband & family, Talking to Friends/Socialising, Mindfulness, Going to Church, Keeping a routine including going to work, Using my light box, Reading, Singing, Watching things on TV I enjoy, Listening to radio and music, Doing things I know I can do, Write a blog, Chat on Twitter, Online Counselling, Taking small amounts of medication to help anxiety symptoms, Monitor my sleep & use small PRN if needed even when well.

Closely linked to these is the ‘Daily Maintenance’ (Things I should try and do everyday) which include:

Keeping a routine, Eating 3 meals a day, Getting some rest, Taking regular breaks at work, Resting at home everyday, Reading for 1/2 hour everyday, Have a shower, Do something I enjoy, Keep my mind active, Mindfulness, Get out of bed everyday 

It is then important to identify ‘Triggers’ which for me are:

Tiredness, Emotional events, Seeing people that may of caused me distress in the past, Skipping meals, Too much stress at work, Spending too much time alone. 

I also need to remind myself that sometimes I can become unwell without experiencing any of these triggers. 

If any of these triggers occur and do affect me negatively or I think they might I try and implement a ‘Triggers Action Plan’ which is:

To try and stick to my daily maintenance plan, Call someone on my support list, Practice mindfulness, Remembering it is ok to care for myself.

‘Early Warning Signs’ are probably fairly crucial for me as it is knowing when to recognise them but not to panic about them before they arrive. For me these are:

Not sleeping more than about 4 hours per night, Slight paranoia, Anxiety in certain situations, Becoming very low, Spending too much money, Racing thoughts, Slight Hypomania, Not enjoying things.

If I notice these signs I then try and implement an action plan based on these which is now going to include calling my GP at this stage.  

I did call my GP when I became unwell in February and noticed the Early warning signs. This did help me feel more supported and also enabled my GP to refer me to CMHT – the fact I am still waiting for an appointment 2 months on is awful but if CMHT can get their act together GP intervention at this point is crucial. The other important things in the Early Warning Action Plan are asking for some help from support list to implement daily maintenance plan, Ask people for help and support, Try to have company where possible, Start using PRN – probably promethazine, Talking worries through with people.

When things are getting worse I will often notice some or all of the following symptoms:

Experiencing Depression all of the time instead of it coming and going, Wanting to sleep all day but not able to sleep at night, Anxiety getting worse & shaking some of the time, Not eating at all without prompting, Having thoughts of suicide, Hearing or seeing things that others can’t, Paranoia so bad that I can’t leave the house easily.

If these signs are present then again I try and implement an action plan: 

Call GP and update her that I am in crisis, Try and ensure I am not on my own, Talk with people who are able to offer support, Think about taking Diazepam to control symptoms, Talk to work about implementing flexible working and other reasonable adjustments, Discuss with someone about attending A&E as a last resort but ask for help from support network to do so,  Ask for support in monitoring PRN so that I am safe, Identifying where on the scale my suicidal thoughts are. 

This is obviously my own plan and is what works for me. I find it helpful to carry my WRAP & care plan from the GP with me to show to other professionals I might meet. This WRAP helps me to feel more in control which I find really important. I constantly re-visit this WRAP and share its contents with those involved in my care. It has also proved useful at work to ensure I am supported correctly.

When I do finally receive a CMHT appointment I will ensure that this WRAP is my starting point for discussions with them. I need their input to work with this plan so that hopefully earlier intervention can lessen the time I am unwell and the need to attend A&E. 

In Limbo wondering what my mood might do next!

This time last week I was hypomanic in fact every day last week I could quite easily have worked another full day, my mind was racing and in certain social situations I had increased confidence. This also had negative symptoms as well and for the last 2 weeks the hypomania has presented different symptoms including anxiety. On Friday I noticed that my head and actions had calmed significantly however I have been left with the most frightening paranoia and I am terrified that I am going to enter a depressive episode and that is something I can’t seem to shake off.
I know that sometimes I can experience hypomania and then a period of relative stability however I also know that depression is an option and the last couple of episodes have gone this way and in a dramatic fashion.
A day or even an hour at a time is the best course of action for the next few days. Apologies for short blog but struggling to get my words out or make much sense. Thanks for reading.