anxiety

Wellness Plan – Wrapping It Up

Peggy Rice2 Comments

I’ve now written several blogs about my Wellness Recovery Action Plan, or WRAP. And it’s time to finish off this series.

The next two sections of the WRAP plan are entitled “When Things are Breaking Down or Getting Much Worse,” and “Crisis Plan.” I’m lumping these together because both point to severe symptoms, and the potential imminence for a relapse of my depression.

According to Wellness Recovery Action Plan (Advocates for Human Potential, Inc., copyright 2018), “sometimes, even when you’ve been making your best efforts to stay well, things can get a lot worse. Some people call this a breakdown, a setback, or a relapse….often your behavior changes so much that other people can tell something is wrong…Taking immediate action can make a difference in the outcome.” In fact, I might be able to avoid the Crisis part of my plan if I can successfully turn this situation around.

Some of my key indicators that things are getting much worse include that I am staying in bed, isolating. I feel anxiety and a heaviness in my chest, an urge to drive fast and recklessly, a desire to smoke e-cigarettes (I’m a non-smoker). I may have increased trouble concentrating, which was also a red flag in my Early Warning Signs.  But in this case, it would be worse. I’d be feeling like a burden to everyone around me. I may have the desire to self-injure or have suicidal thoughts (called suicide ideation – thoughts, but not a plan), and I’d find myself unable to pray. I’d dread the future and ruminate on the past. I’d have flat affect – expressing very little emotion.

So what do I do if things get much worse? First thing – tell someone! My husband, sister, or close friend. Call my therapist and psych doc right away. Reduce caffeine – drink herbal tea instead of coffee – and sit in my glider, which I find very calming. I would try to Face Time my old therapist – he can often “talk me down.” I think I’d call in my second round of support – three other close friends who I know love me and would offer me encouragement and prayer. Perhaps, if these steps work, a relapse would not occur.

The Crisis Plan portion of the WRAP is designed to make it as easy as possible for people to help me, because if I am in a depression crisis, I might not be able to make my own decisions. It outlines who I want to help me – by name – and exactly what I want them to do for me. Things like get me to the hospital emergency room, sit with me, hold my hand. And what I don’t want done, like what medicines I can’t take. It even outlines my daytime and household responsibilities and who will do them, like care for the pets and pay my bills and contact and keep my prayer team updated.

After the crisis has passed, the Post-Crisis Plan is implemented. It’s a brief section of the WRAP where I identify things that worked in my WRAP Plan, and things that need to change. Perhaps there are people I need to thank for their help in my crisis; perhaps there are apologies or amends I need to make as a result of things I said or did during my crisis.  This final portion of the WRAP allows me to step back into the responsibilities of my daily life, slowly, as I begin to return to my normal level of wellness. This may take time – crisis recovery is not immediate, and I will need to be patient with myself. But this is a good time to evaluate and make changes to my WRAP, as I can see what worked and what didn’t. Because post-crisis can be very introspective, it’s a good time to modify my WRAP to include stressors or early warning signs that I may have missed before. I can add to the Crisis portion of my plan while it’s still fresh in my memory – what additions do I need to make so that, heaven forbid, things go more smoothly the next time?

Ultimately, the goal of the WRAP is to help me avoid a depression crisis – to identify those markers ahead of time to avert another hospitalization or emotional break down. Because this plan is so thorough, I may be able to stay in remission for the rest of my life.

Wellness Plan – Stressors

Peggy Rice1 Comment

If you’ve been reading this blog lately, you know I’ve been working on my Wellness Recovery Action Plan – WRAP. I invested in the guide from Mental Health Recovery – it gives more explanation, details and examples than the WRAP app did. I’m really glad I bought the book – I’ve found it very helpful, and have added to my Wellness Toolbox and the next step in the process, The Daily Plan.

The Daily Plan is an outline of what I look like – my moods and attitudes – and what I “do every day to stay well and stay on track with my goals.” (Reference: WRAP app) It includes an outline of a typical day of wellness. It was fairly easy to write.

The Stressors section was much more difficult. Stressors, sometimes known as triggers, are “things that happen that can cause a reaction. Sometimes they are reminders of specific events, or they may evoke a feeling that takes you back to a time when you felt helpless, scared, or out of control.” (Reference: Wellness Recovery Action Plan – Renewing Your Wellness Your Way, copyright 2018)

The first step was to write down “things that might make me feel unwell or throw me off track if they happened” (Reference: WRAP app) and just the question sparked anxiety in me. I started with a list of five stressors – certain times of year, when my husband travels, when my meds stop working, grief, and major life transitions. But as I worked on this section with help from the book, I came up with seven more. That’s a total of twelve potential stressors! Argh!

Thinking of these stressors was difficult – indeed, it caused a stress reaction in my body. Heart racing, shallow breathing, a lump in my throat. I put the list away several times to take mental breaks from it – had to calm down before I came back to it.

Working on the relief to those stressors brought relief to my physical reactions. Again, originally I had twelve stress relievers, but with the help of the book and deeper consideration, I came up with a total of 22 tools to use when stressors hit my life. Things like walking around the block, savoring a cup of tea or coffee, reading fiction, sitting in my glider, practicing deep breathing techniques, writing in my gratitude journal. These are good wellness tools to add to my mental health toolbox.

I know the process of writing the WRAP will continue to be difficult. The next two sections are When Things Are Breaking Down or Getting Much Worse, and Crisis Plan, which first caused me anxiety when I read about it. And while the point of the plan is steps toward mental health, it’s anxiety-producing in the process of writing it. But I’ll take my time and persevere, because I’m sure the end result – my personalized detailed wellness tool – will be worth it.

Post script – in an effort to be transparent and maybe helpful to someone else writing a WRAP plan – here is a complete list of my stress relievers:

  • See therapist
  • See psych doc
  • Tell husband, sister, and friend that I’m struggling
  • Nap
  • Walk around the block
  • Dance
  • Savor a cup of tea or coffee or mocha
  • Journal
  • Pray
  • Watch Netflix
  • Read fiction
  • Coloring books
  • Knit
  • Listen to playlists (I have several made for my “moods”)
  • Gratitude journal
  • Tell folks at Fresh Hope support group and ask for prayer
  • Coffee date w/friend
  • FaceTime w/my kids
  • Take a break from obligations (work, volunteering)
  • Practice deep breathing, relaxation techniques
  • Rock in my glider
  • Have a date with my husband
  • Take a trip to see the kids

Depression at Night

Peggy Rice10 Comments
dark darkness loneliness mystery
Photo by Engin Akyurt on Pexels.com

Depression always feels heavier at night. And I just wanna be alone.

I love my husband deeply, but right now, I want to crawl under the covers in a pitch-black bedroom by myself. I’m sorry, honey. No offense intended.

I don’t want to talk to anyone. I want to be alone with my thoughts and my mood. This is not a healthy choice, but it is an overwhelming desire.

Depression has a way of telling me that I’m all alone anyway, and pressuring me to feel it. This disease wants me to ruminate – to think dark thoughts over and over. Or to think no thoughts at all – to let my mind be blank. That’s not easy for me to do normally, but it’s pretty simple in my depressed state.

I would love to huddle in a space where no light gets in. To sit in silence and blackness. To be covered by a blanket of dark. To hear nothing but the echo of no sound. So that I can listen for my heartbeat – a reminder that I’m alive and fighting. Barely. But fighting nonetheless.

I’m drawn to the corner of a room, or the floor of a closet, or in the dark next to a large heavy piece of furniture, such as a dresser or bookshelf. I’d like to just sit there, with my knees pulled up to my chin and my arms wrapped around my legs. I’d be wearing my most comfortable clothes – soft sweats and fluffy socks. My eyes would slowly adjust to the small amount of light filtering in, but I’d be surrounded by the dark. It would be comforting.

Depression often brings its friend, anxiety. A hollowness behind my sternum, an emptiness in my stomach. My long-time therapist recently encouraged me to identify where in my body I’m feeling my emotions, as they are a whole-body experience. So anxiety is in the center of my body.

Depression is on my shoulders, pulling me down and forward. Like a thick pile of blankets would feel – heavy and warm.

Isolation is a very familiar feeling, comforting, enticing. I’ve felt it before, and I long for the peace it brings. But two things I know: it’s not a lasting peace. And I’m not truly alone – Jesus is with me.

The stillness that depression brings invariably turns to negative thinking, to self-accusation, to feelings of hopelessness. My mind goes from no thoughts to condemning thoughts to lonely thoughts.

And the presence of Jesus – the Light of the World – counters the darkness. He longs to comfort me in my isolation, to remind me that He will never leave me, and that nothing – not even the darkness – can separate me from His love.

I could ask the darkness to hide me, and the light around me to become night—but even in darkness I cannot hide from you. To you the night shines as bright as day. Darkness and light are the same to you. Psalm 139:11-12, NLT

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I realize this is a “dark” entry. It’s how I feel as I go to bed at night when I’m in the midst of a depressive episode. I felt this way, too, every day of my worst depression back in 2009.  Fortunately, these feelings don’t last all day long anymore!

Anxiety Revisited

Peggy Rice1 Comment

So I got news yesterday that concerned me. No, more than concern. It brought worry and anxiety. My mind raced eighteen steps ahead in my worst-case-scenario storyline. It was not pretty.

I haven’t had anxiety for a long time, other than a single moment a few weeks ago. But that flash of anxiety was just that – a flash, momentary. It lasted long enough for me to recognize it, but my thoughts immediately turned to God’s truth, and the anxiety was gone – snap! – that fast.

This time, it’s lingering. I’m worried about something in the future that I can’t control. That’s where anxiety looks – ahead. Depression looks back. This is why it’s so important to stay in the current moment – so as not to entertain anxiety (future worry) or depression (past regrets).

Anyway, this fear for a future moment is for an inevitable event; I just don’t know when. And the not-knowing scares me.

Anxiety presents itself in my body in both my belly and my lungs. My stomach feels hollow, and it’s hard to catch my breath. It’s a physical reaction to an emotional response. My stomach hurts and I can’t breathe.

I hugged my husband tonight when he got home, and told him I was scared – he didn’t even ask about what. He knows what worries me, even though I’ve been careful not to dwell on the future or even express it. As if expressing it out loud could make it happen – which it can’t.

The sermon on Sunday was about peace. I’ll go back and review my notes, because I need them right now. I need the peace that Jesus brings. He says, “I leave the gift of peace with you—my peace. Not the kind of fragile peace given by the world, but my perfect peace. Don’t yield to fear or be troubled in your hearts—instead, be courageous!” John 14:27 (TPT)

In other places in God’s Word, it says:

Let the peace of Christ rule in your hearts, to which indeed you were called in one body; and be thankful. Colossians 3:15 (NASB)

“Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.” Philippians‬ ‭4:6-7‬ ‭(NIV‬‬)

I was thinking about that word “guard.” God’s peace will guard my heart and my mind – will protect it, keep it from being attacked by outside forces. By anxious thoughts.

At this time of year, we celebrate that Jesus came as a baby. The Prince of Peace. (Isaiah 9:6)

May He reign in my heart and yours. Right now. Because we all need His Peace.

Depression and Answered Prayer

Peggy Rice3 Comments

I’ve struggled with depression for over ten years. I think I’ve had more than a dozen different depressive episodes, some much worse than others. In my hopeful moments, I begged God to not waste my pain, to allow me to use it to help others. But mostly, I couldn’t see anything good in my suffering.

For those of us who struggle with mental health, it’s very isolating. There’s still so much stigma surrounding mental illness: people don’t understand it. How could I be a Christian, let alone a leader and Bible Study teacher, and still be tormented by these feelings of uselessness and hopelessness? What kind of witness was I to my friends and coworkers? A failure! I felt very alone, even at church.

I didn’t want church friends to know – I didn’t want to be judged as sinful. I didn’t want work friends to know – I didn’t want to be judged as weak. But as the illness progressed, it became more and more obvious that I was unable to do my jobs. Others had to start picking up the pieces I dropped. Not to mention the days I didn’t have the strength to go to work or Bible Study at all, so I’d call in “sick.” I always felt horrible, knowing they would have to scramble to cover my responsibilities as well as their own. But I couldn’t help it. I was unable to leave the security of my bed and the safety of my home. I couldn’t face glaring lights, traffic, or people.

I didn’t know how God was going to redeem this, make anything good come from my pain. And as I got deeper into the illness, it became harder and harder to hide from the people around me.

So I thought God might work through awareness, as my friends saw me struggle. Perhaps I could give them a glimpse, an understanding, of what depression is and does. Maybe that was how God would use my pain for others’ benefit. Maybe, by being ill and unable to hide it, I could reduce stigma. “See? It can happen to anyone!”

In the darkest times, though, I didn’t care if others understood, or what God might do with my struggles. I was simply trying to survive, to hang on through another day of excruciating mental pain and feelings of anxiety and hopelessness, with physical manifestations of weariness, head and body aches and stomach pain. I dreaded going to bed because it just meant another day of the same tomorrow. Unless perhaps I wouldn’t wake up…the thought was appealing. I begged God for the Second Coming – the only way in which I could see my pain ending. That or death, which I was too afraid to try, though I thought of it often.

Depression is that way, trying to get me to think that no one understands, no one cares, and it will never end. In the very darkest times, I even wondered where God was, and felt like He’d abandoned me in my dark cave of negative self-worth.

But God had not abandoned me. Jesus was right by my side, and He wasn’t tapping His foot and telling me to “hurry up and get better.” He was sitting alongside me in my pain, comforting me and reminding me that He loves me so much. He was crucified for me, and for the pain of depression. He had died on the cross to give me eternal Hope. And as I sl-ow-ly emerged from the darkness of depression, God gave me the opportunity to serve Him with my illness.

Fresh Hope is a peer-led support group for people with a mental health challenge – and their loved ones. Just this week, I was part of a team which started a Fresh Hope Group at our church. The organization is about creating a community where we learn to live a rich, faith-filled life, in spite of having a mental health challenge. It’s for anyone who struggles with mental illness – depression, anxiety, obsessive compulsive disorder, bipolar, PTSD, schizo-affective disorder – and for anyone who loves someone who is hurting in this way.

“And we know that God causes everything to work together for the good of those who love God and are called according to his purpose for them.” Romans 8:28, NLT.  He’s doing that for me through this Fresh Hope Ministry – working all my pain from depression for my good and for others.  In Fresh Hope, we’ll encourage each other, and comfort one another with the same comfort we’ve received from God (see II Corinthians 1:3-4).

I have suffered, and therefore have the privilege of understanding. Of having gone through the valley of the shadow of death, and emerging on the other side. I can relate to the hurting who come to the group. God is using my illness to help others. And further healing me in the process.