Having a mental illness is not a joke, it’s not made up and it’s not easy to live with. Whether I am flying high in hypomania or sinking to the depths of depression I am not thinking rationally. The tools that I have learned over the years are forgotten as if I never knew them. This puts me in a difficult position because I need those tools to bring myself down or pick myself up. Without them, I get swept away into other worlds that begin to be difficult to get out of the longer I stay there.
I think this is a common problem in people who struggle with mental illness. It definitely holds true for the various aspects of my mental illness. Even in my anxiety, I start to lose focus of the goal and begin to panic more. I forget to breathe, reality check and start obsessing. When symptoms of our mental illness get worse it’s almost as though we get trapped in our head at that moment and forget everything else. Think of it like this; life is a boat on the ocean and my various mental illnesses are a fishing net. When I get thrown overboard by a big wave (meds not working, bad day, circumstances) I get wrapped up in the fishing net and am unable to swim back to the boat (life). It’s right there, not even 3 meters away but I can’t get there and the longer I don’t swim back, the further away I drift, the harder it becomes to get back, and a vicious cycle begins. I need help to get back, someone to simply reach out their hand or throw a rope. So how then do we get back to the boat if there are no hands reaching out or ropes being thrown?
For me, well I write lists. Lots and lots of lists. I have a list for pretty much every situation or feeling. I don’t need to use them as much as when I originally made them but they are all still around in notebooks for when I need them. Lists tell me what to do when my brain is not working correctly. They let me know what the next right thing to do is when I can’t remember. These lists have saved me time and time again from spiralling higher and deeper into my ups and downs. Some of the lists are steps to follow, some are checklists, some are more tangible with actual items and some are just lists of information, but each of them has helped me get through dark moments and bring me back to reality.
I thought I would give you some examples of my lists below if you ever wanted to put your own lists together or maybe help someone else do it.
Distraction and soothing lists
Because of my Borderline Personality Disorder and Bipolar I often need to distract myself from the feelings I am experiencing because they become so overwhelming. For this, I created a distraction box with a list stuck on the inside of everything there. I put in things that would take my mind off the panic I was feeling, the urge to self-harm, my irritability or any of the overwhelming feelings of distress I was feeling. Creating the box was also a great process. First I found a nice-sized box and decorated it. For me, it was a collage of images that I wanted to achieve one day or that made me happy. Then I filled it with items like; a movie (one that made me smile and one that made me cry), a scented candle (vanilla as it’s my favourite scent), something to do with my hands (I put in my beading tools and some beads as well as a deck of cards), a USB (with 3 playlists – for mad, glad, sad moods), an envelope with R50 (so I always had money to go for a coffee if I needed it), etc. You would need to figure out which items would help you and calm or distract you for yourself. I used this box so many times it became worn and I had to replace items in it but it worked every time. To see how to build your own distraction box, check this article out.
Sometimes though, I need more soothing than just a distraction so I also put together a self-soothing box. This box was a lot smaller and could actually fit in my bag to carry around with me. You can make it so small it fits into a matchbox. A great way to soothe ourselves is to use our senses so I put together a list of actions to take that engaged with my 5 senses. Then I cut each of the actions out, mixed them up and popped them into a little box. Every time I started feeling distressed I would grab my box, pull an action out by random and do what it said. Some of my actions were; going to a park and playing like a child, lighting a scented candle, slowly eating my favourite food or sweets, going for a massage or haircut, or listening to some music. As I engaged my different senses I calmed down and felt better. For some more examples of self-soothing actions and putting your own kit together you can have a look at this article but remember to put some of your own in there. Things that make you feel better, calmer and loved. For instance, having a haircut is always on my list because it brings memories of my gran back and I love the sound and feel of the scissors cutting my hair, for me, this is really soothing and always makes me feel better.
Doing the next right thing lists
These are lists that I put together and paste all over. They tell me what to do next, a list of steps to take when I can’t think of what I need. One of the lists I keep handy is the names of people I need or can call. It’s just a straight-up list with 20 names. Top of the list is my sponsor, then another name, and so on. The rule is that when I start to panic or want to do something stupid I start at the top of the list and work my way down. Only once I have tried all the names do I have permission to act on my thoughts. I also have a list of actions to follow when I am deep in depression, a checklist of sorts. Make your bed, brush your teeth, have a shower, eat something, take your meds, leave the house, get dressed. This type of checklist keeps me moving on a daily basis and often helps me not sink even lower into the blackness. I also have lists to help me manage my mental health and recovery that I try to keep to, things like attending a 12-step fellowship meeting a week, going to mental health support groups, seeing my counsellor regularly, etc. Lists like these help me keep on track with life, keep me in check and keep me from acting out or doing stupid things. Some of them are stuck around, some are in books and some are hidden away for emergencies. In the beginning, these were the most important lists but over time and as I used them over and over they became habitual for me. I don’t actually need the pieces of paper as much anymore as the lists are ingrained in my head now. I have used them so often they have become second nature which is really helpful in moments when my brain switches off.
Managing anxiety lists
Anxiety and panic attacks can often be the most debilitating and paralysing things to experience. Lists with actions, distractions and soothing techniques can be of tremendous help in these moments. One of my biggest anxiety provokers is lateness, for myself or others. I suppose when people are late it brings about fears of being forgotten or abandoned. To help me get through it and avoid a panic attack I follow a list of instructions. They go something like this if I am getting picked up at 3 pm and the person is not there yet I have to give them 5 minutes (there could be traffic or something), then I need to send a message – if they have not responded within 5 minutes to that I am allowed to call them. Normally I would then find out what is happening and the time is readjusted and panic averted. If there is no answer I need to allow for 5 more minutes and then call again. After following all of these steps with no resolution I am then allowed to panic. In over 13 years I have never actually reached the ‘allowed to panic’ stage of my list. Having lists like this acknowledge the fears and anxieties but also put in some actions before allowing it to take over. I also know that I panic when having to make big decisions or make changes, I become terribly overwhelmed and anxiety kicks in. Once the anxiety kicks in I am useless and no decisions or changes get made. So I follow another list of suggestions. Firstly, not thinking about it for longer than 20 minutes at a time. Often writing a list of pros and cons will also help. Sometimes I call my mom and chat it through with her. Other suggestions on the list are doing a bit of research, planning the change on a piece of paper or mapping it out and distracting myself when I start to feel overwhelmed until I am calm again.
To even begin putting these lists and suggestions together, I have to start by becoming aware of what my anxiety triggers are. This is hard in the beginning but by trying to be more aware more often it becomes easy to pick up what things or thoughts are triggering my anxiety. Once I have this list (and I can continue to build on it and add changes) I can start thinking through what will help me in each of those situations. These lists are the hardest to put together and I had my counsellor help me with many of the first lists I put together. She gave me suggestions for the lists and helped me work out where the triggers were coming from. It’s important that you allow people around you who know you to support you by putting these lists together. It’s also helpful to speak with other people and see what has helped them manage their anxiety. Listen to everything with an open mind, take what you need or might help you and leave the rest behind. Everyone is different so what works for one person might not work for you but if it possibly can then it’s worth trying. Putting together the distraction box and soothing kit will also help and be handing to have around for when you do start having panic attacks.
Informational lists
These are really simple but can also be life-saving. I have a list written down with all my support team’s information, so email addresses, telephone numbers (office and cell if possible), addresses and office hours with emergency numbers if they have any. I keep this for my counsellor, psychiatrist, doctor, sponsor and preferred hospital. It’s handy for me to have when I can’t think but it’s also handy for the person helping me to have if I am incapable of thinking due to an accident, unconsciousness or psychosis. I have another list with all the information for support groups and helplines in the area. There is so much information out there and so many different support groups available that I think it is really important to make a list with the information. For instance, I know that in my area there is a SADAG meeting twice a month, a Bipolar support group once a month and a mental health support group once a month. I have the times, dates and addresses for all these meetings. I have telephone numbers for all the hotlines and a meeting list of all the various 12-Step Fellowship meetings in the Western Cape. I also have information for several other helpful things like Crazy for Walking, which I join most months and ongoing groups or classes for things like depression, anxiety, self-esteem, art classes, etc. Some of these are free and some are paid for but they are handy to have.
Here are some sites where you can find this information:
SADAG
Bipolar Support Groups
Healing Spaces
Cape Mental Health
NA Meetings | AA Meetings | CODA | SLA Meetings
(Please note that these are mostly in South Africa and Cape Town but I encourage you to find out what is in your area)
We all have different ways to work through and manage our mental health, writing lists has always helped me tremendously. I hope that you have either found some of these helpful or been encouraged to find out what might work for you. When we struggle with a mental illness it is important that we look after ourselves and put everything in place that could help us daily. Do the work, spend the time preparing and the extreme highs and lows might become more manageable or at least you might become aware more quickly that you need to reach out to your support team. Please comment with any further suggestions you might have, we have to stick together and help each other as much as we can.