mood

Wellness Plan – Early Warning Signs

Peggy Rice1 Comment

The next step in the WRAP Plan is to list the signs that indicate I need to take action before things get worse. They are changes in the way I think, act or feel, so they are observable, either to myself or others.

This section of the Wellness Recovery Action Plan requires that I face my fears about the initial red flags which indicate an episode is possible. It’s more than just Stressors; it’s actual changes in my thinking and behaving. This is a key part to the WRAP – to recognize these signs as serious and do something about them before they get worse!

These are behaviors or attitudes that point to a potential problem – perhaps a descent into a mental illness episode. For me, indicators include things like listening to my music really loud – perhaps to drown out my spiraling negative thoughts. I apologize a lot, and have excessive guilty feelings. I have a strong desire to speak to my old-time long-term therapist, Ted. I find it hard to concentrate, even for a short TV sitcom. I begin to think “What’s the point?” which is an elusive question, as I don’t define “it;” I guess I just feel fatalistic. I desire to be alone with my self-blaming thoughts. I have trouble making decisions, feel easily overwhelmed, and have a lack of energy.

The Wellness Recovery Action Plan book (copyright 2018) suggests that I review this list of early warning signs regularly, perhaps even daily, so that I become familiar with them and can respond before things get worse. A list like this can be an inventory of emotions and behaviors to note. If I am experiencing several of them, I need to ask myself what’s going on, and why I’m feeling out of sorts. And I need to put the next part of my Action Plan into place.

The wellness tools I will use if I see these early warning signs are:

  • Tell my husband, sister, and friend
  • See my therapist
  • See my psych doc
  • Listen to my music playlists that are encouraging and uplifting
  • Have a coffee date with a friend
  • Rock in my glider
  • Try to interrupt the spiraling thoughts with the truth of God’s Word
  • Email, maybe even FaceTime, my old therapist.

Other actions might be to take a walk, or do some stretching exercises.

In the future, I might make this into two lists – one of actions I must take, and one of actions I might take, when I observe these early warning signs. And I can always go back to my Wellness Tool Box and pull activities from there to help me avert a depressive episode.

Wishful thinking.

Peggy Rice8 Comments

“Just pray harder.”

“Why don’t you take a walk in the sunshine?”

“Count your blessings!”

“There are so many who are worse off than you.”

And my mantra: “This, too, shall pass.”

All of these are perhaps well-intentioned, but unhelpful pieces of advice for a depressed person.

I can’t think myself out of depression. Though this time I really tried.

Each day, I answer a mood question, “On a scale of 1-9, how’s your mood?” And when I’m in a healthy mental state, my mood runs at 7 or 8. (9 and 10 are reserved for “extremely good” and “exceptional,” which usually happens when my husband and I are on an adventure or my whole family is together.)

Shortly after Christmas, my mood started running at 7 and 6. Then it dropped down to 6 and 5. Then it was solid days of 5.

I felt like I was handling 5. I didn’t see it as concerning. I was still going to my job, my volunteering. I came home and was tired, but that’s not unusual – it’s the middle of winter, so of course my mood is down a bit.

I started having trouble sleeping – waking at 2am or 3am for a couple of hours, night after night. I wrote it off to being in my mid-50s, that time in my life, etc.

I stopped reading my books, including ones I had been excited to devour. I couldn’t concentrate. And some of the Netflix shows we watched didn’t hold my attention for the entire hour. I’d get up and get a snack: “No, don’t pause it; it’s ok; I’ll be right back.”

I told my friends that I was fighting depression. And I thought I was. But in reality, I wasn’t doing anything but letting it take me further down the tunnel.

I thought it would go away. I thought I would bounce back. For six weeks I let it push me deeper and deeper, but I kept denying it. Or at least minimizing it.

The thing about depression is – my brain is broken during an episode. I don’t think clearly. So I couldn’t see that depression wasn’t going to go away by itself. Even though I know better, I somehow thought that I could will myself out of depression.

I told my husband that if my mood dipped to 3, I would see the psych doc for a med adjustment. And my mood dipped to 4, for several days in a row.

At the same time, I caught a bad head cold, so I continued to “write off” my mood – this time because I wasn’t feeling well.

And then, I tanked. My mood hit 3. I left a message for the doc that I needed to see him.

On our way out of church Sunday, my husband encouraged me to not beat myself up for taking so long to see my psych doc. He reminded me that I gave myself parameters, and I abided by those guidelines: mood = 3 means call for a med check.

I admitted that I am beating myself up a bit. I know better! I know depression doesn’t go away by itself. But he’s right – I did what I said I would do.

I met with the psych doc this morning. He doesn’t want me to plummet (too late), so we’re boosting two of my meds. And because I took my fine sweet time getting in to see him, I’m going to be on these adjusted meds for several months. Hopefully, it won’t take that whole time to begin to feel better.

It is true: “This, too, shall pass.” But not without a helpful push from the doctor.

Not giving in!

Peggy Rice5 Comments
My new tattoo

I mentioned a few posts ago that I’m fighting depression. And that’s exactly what I’m doing – fighting!

My mood continues to want to pull down, but it hasn’t stayed there. I’m not walking in the deep dark yet. I’m still standing upright, and while I’d like to stay in bed each morning, I’m not. I’m getting up, getting dressed, and doing the tasks at hand.

This is good news! This is me fighting for mental health, not the mental illness of depression. This is me trying to live a rich and hope-filled life.

When my depression was at its worst, I would wake up under the dark cloud of depression. It was hard and heavy and lonely. I would struggle to find joy in anything, even my morning cup of coffee.

But this time around, it’s not as bad in the mornings. My mood deteriorates as the day progresses, but it doesn’t start down.

I’m not sure why it gets worse as the day wears on. I always notice it in the car, when I’m driving for any longer than 10 minutes. I think it may have to do with being alone. Don’t get me wrong; my satellite radio is tuned almost exclusively to the contemporary Christian music station. My playlists are full of wonderful worship songs by Dove Music Award winners. I know lyrics to hundreds of songs by favorite worship artists. But it almost makes it worse, as I find some of the songs reminding me of darker times.

Per my friend’s suggestion, I’m trying to figure out how to listen to one of my Kindle books as I drive, instead of music. Maybe the distraction of a story will keep me from ruminating.

It could be that I’m just getting tired as the hours stretch toward evening. Perhaps that lowers my resistance, and it’s easier to succumb to the pull of depression, the spiraling thoughts, the loneliness.

Each day at 5:45pm, I get a text message to check in on my mood. It’s too bad that it’s in the afternoon when I’m feeling my worst, but maybe that’s the most accurate time to evaluate. Usually, my mood runs at 7-8-9. Lately, it’s been 5, dipping to 4. I’ll be concerned if it goes down to 3.

I haven’t been to see the psych doc yet – I feel like I’m battling successfully without a med adjustment. But should I have several days in a row of a real low mood-score, I promise to call his office.

In the meantime, I’m still looking for a new therapist. I hope that talking to someone will help me manage the depressive symptoms, and I won’t need more meds.

It’s a blah day, not a relapse.

Peggy Rice15 Comments

For many mornings in a row, when the alarm goes off I think, “Why bother?” I get up because that’s what I do, not because I want to. I have nothing to get up for. And then I remember that I intentionally planned something into my day so that I will get up. Otherwise, I think I’d stay in bed all morning.

I’ve had several days of feeling “in a funk” – not really happy but not really sad either. A blah mood.

A year ago, I would have blamed all of this on the weather – the gray clouds of the upper Midwest that cover the sun for days and often bring snow and cold. But I’m in Florida now, and while it’s been unseasonably rainy, there was sunshine and even warmer temperatures today. So what’s my problem?

I think it’s because it is February. And traditionally, February has been a tough month for me. According to my old psych doc, even though it’s the shortest month of the year, it’s often the hardest emotionally. Not sure why. But perhaps I’m feeling the way I do because I’ve felt this way for the past nine Februarys. Emotional muscle memory.

It took me a few hours today to figure this out – this thing about February. I should have seen it sooner – I knew I was feeling less than good. I kept arguing with myself that the mood would simply go away, and I suspect it will, now that I’ve identified it and called it by name.

A blah day, or even a blah week, doesn’t mean relapse. It doesn’t mean depression again. It means I’m in a blah mood, and I’ll be in a blah mood for a few days, and then it will get better. To keep it from descending into depression, I’ll keep doing what I know to do – eat well, get enough sleep, exercise some, take my meds, reach out. Get up and do the day.

And if I need to take a day to stay in bed all morning, that’s ok too.