Today I learned about positive self-talk.

     Today my therapist introduced me to the concept of “positive self-talk.”  According to her, this is the practice of, instead of focusing on the negative, talk through the positives.  For instance, I am often plagued by nightmares and wake in a confused state not sure where I am or what is going on.  Instead of focusing on how the dream made me feel; instead remind myself that it is over and that it cannot hurt me.  I am supposed to use this technique any time I begin my usual process of negative thoughts.

     This is in conjunction with a “thought record.”  This is a record of how I am feeling at a particular moment, what was happening at that moment, the negative thoughts that influenced my feelings, and more realistic thoughts that lead to (hopefully) a better set of feelings.  Ideally this is an actual physical record, though generally I don’t keep one around me at all times.

     These two things are “tools” in my so-called “toolkit.”  These are things that I can pull out and use when the negative and anxious thoughts begin to creep in.

     So how about you, what tools are in your toolkit?  Do you practice positive self-talk?

--JJM

More thoughts on news media and mental health.

     I was talking to my wife the other night about violent crime and mental illness.  She thinks that a person’s mental health issues can be pertinent to a crime; that people want to know why it has happened and that if a person who committed these crimes has a mental health issue it gives light to a possible reason as to why it happened.  I think that this is true to a certain extent, but I maintain that without asking the person why they committed the crime there is no knowing the true reason as to why they have done so.  We both agreed that the news media needs to portray more positives in the mental health community to promote the idea that people living with a mental health condition are just normal people, just as much as those who live with other health conditions.

     It is a tricky position to be in.  Admitting to the world you have any kind of invisible illness invites skepticism, if not worse.  On top of that, there are the sorts of discrimination that people with mental illness must always face.  Not everyone is strong enough to admit their condition, nor should they be forced to.  I fear that the media will always focus on the negative things that those who suffer with mental illness must face and ignoring the serious strength and courage that it takes to continue on in the face of the, sometimes great, adversity that they live with.

     We do not face this alone, however.  We often have allies, a loved one, a dear friend, or perhaps even a complete stranger.  These allies should take a more active role, if they can.  There are advocacy groups such as NAMI, but I do hope that more “ordinary” people stand up for those they know who live with these types of conditions such that the media would have a hard time making them out to be the villains they may not even truly be.

     I am not entirely sure how to go about ending the vilification that those who must live with a mental illness must sometimes face, but I do know that we cannot do it alone.  So I suppose I am calling out to others who live with, know someone who lives with, or is just a general ally of those who must face these challenges (often alone), to come to attention and speak up on behalf of those who may not be able to speak up for themselves.

     So, if you could do something to help end this form of discrimination, what would it be?

--JJM

The importance of routine.

     Every weekday morning I wake around 7:15 AM, take my medication, and get ready for the day.  After returning for the day I wash the dishes and start dinner.  After eating I sit and attempt to write for at least an hour.  After writing I have about an hour’s free time before taking care of the cats and getting ready for bed.  I am usually in bed between 10:00 and 10:30 PM, and fall asleep around 11:00.

     Weekends are a bit more lax, in the waking time, but I still go to bed at about the same time.

     It is important to have a routine, especially with bipolar.  Routine keeps me stable; at least it helps.  I know I get very upset when my long time routine is disrupted; specifically when I am informed of plans at the “last minute.”  I need at least a week, preferably two, to process the plan and become okay with it.  This is partially due to a disruption in my schedule needing to be taken into account and worked around, but another large factor is the anxiety associated with change.

     Routine makes it harder to forget things like showering or taking medication.  Also, and perhaps most importantly, sleep routine regulates my mood.  If I stay awake all night (something I haven’t done in over a year) I almost certainly swing into a manic state.  Going hand in hand with this, I limit my caffeine intake to about two cups of coffee a day, in the morning, and no more throughout the day.  This gives me the little pick-me-up I seem to need in the morning without keeping me up at night.

     My wife helps me stay on track with my daily and weekly routines, making sure I do what is needed.  She also asks why I didn’t stick to my regimen.  Adhering to a strict schedule can be difficult at times, but I know it is what is needed to keep me well, and that is very important to me.

     What types of routine do you have?  How does it impact your life?

--JJM

My experiences with sleep paralysis.

     Amongst other things, I suffer from bouts of sleep paralysis.  Sleep paralysis is when your brain wakes up before your body.  I have had many varied episodes and can give an account of them.  Firstly, my sleep paralysis occurs when I am waking up, and usually lasts somewhere between ten seconds to two or three minutes.  Those longer episodes are the more frightening (I will get to why shortly).

     Often these episodes are accompanied by hallucinations.  These can take the form of out of body experiences, feeling as though someone or something else is in the room with me, or some other vivid dream like experience.  When I am having a hallucinatory episode involving something else in the room, I am often filled with a great sense of dread, as though whatever is in the room is going to try and hurt me.  Sometimes this is accompanied by the sensation that something is on my chest making it difficult to breathe.

     While this is occurring I try to move my arms and legs but can’t.  It is as though some unseen force is pinning me down.  I usually also attempt to scream, but cannot.  The most frightening of all is when almost all of these things occur simultaneously; that feeling that something in the room is trying to harm me, while choking the life out of me, as I try to scream to no avail.

     These episodes often leave me feeling very tired for the rest of the day, and when one occurs it is very likely more will as well.  This makes napping a very “risky” choice.  If I fall asleep during the day, there is a good chance that I will have another sleep paralysis episode making me just as tired as I was before the nap.

     I do not remember having an episode until I was in my early to mid-twenties, with no particular trigger that I can remember.  This is not uncommon.  According to webMD, these episodes are supposed to be fairly common with people who suffer from mental health conditions such as anxiety, bipolar, depression, and post traumatic stress disorder (PTSD).  It is also associated with some physical conditions, particularly narcolepsy and sleep apnea.  Despite all of this, by itself sleep paralysis is not considered a major debilitating condition.

     Have you ever experienced sleep paralysis?  What are your experiences with it?  Or, even better, if you’ve overcome it, how?

--JJM

Should you tell other people about mental health conditions?

     When is a good time to tell someone you suffer from a mental health condition?  The answer, as you may have guessed, is highly subjective.  Many factors play a role in the time, place, and manner in which this information should be relayed.  The biggest question, I suppose, is “does this person need to know?”  For instance, it is important when talking to a doctor or other professional about health concerns and medication that you fully disclose your diagnosis, current symptoms, and your list of medications.  It may factor into things like why your blood pressure may be high, or why you are overweight.  Many psychiatric medications are known to cause weight gain, or you may be a binge/emotional eater, in which case they may suggest therapy in conjunction with diet and exercise.

    Telling a partner, or potential partner, can be a rather tricky situation.  I have always made it a point to tell people I am dating very early on that I have bipolar.  This is because it goes to explain some of my behaviours and lets them decide if they want to invest the emotional energy in the relationship beforehand, especially while I was attempting to manage my conditions without medication.  Another important factor is that many mental disorders have a genetic component and therefore may be potentially passed on to children.  As with any genetic consideration you should always tell anyone you may have children with of your contributing factors.

     Letting a friend know of your condition is something that is far more subjective than others.  Does this person need to know?  Exactly how close are you?  Is it something that is likely to impact their life as well?  Depending on how well you know someone it may strengthen the relationship by giving a reason as to why you behave the way you do.  For instance, if you have social anxiety and often cancel plans, letting a friend know that this is the reason you cancel plans could very well lead to understanding and compassion.  If they react negatively or abandon you, chances are they were not a very good friend to begin with.  Strangers and casual acquaintances almost never need to know.

     As I have stated before, having a mental illness is not unlike having any other kind of illness, and a good guideline is if you would tell a particular person about a hypothetical physical illness, then telling them about a mental one is probably okay.  Of course, this is all highly subjective and no one should be forced into telling another person something they are not comfortable with.  If you are not comfortable telling someone something as intimate as your mental health, then don’t.  However, keep in mind that only by openly talking about it can we eliminate the stigma surrounding mental illness.

     I was once talking to someone in the mental health field; they said something along the lines of being less forthcoming about our mental state to those that do not need to know.  I think there is a clear cut difference between being proud of something and being accepting of it.  I do not think that the condition itself is something to be proud of; however a person should take great pride in their victories over their illness.  Just because you shouldn’t necessarily be proud doesn’t mean you should be ashamed either.  No one should be ashamed of something they cannot help or change.

     What are your guidelines for telling someone that you have a mental health issue?  Or, on the flip side, what would you be comfortable hearing someone tell you about their issues?

--JJM