Basic Care

Keep CleanYesterday a crack opened in the bipolar depression that’s been at me for weeks.  Enough to let me remember to return to basics.  Because I’ve looked in the mirror every morning and said to that shocked face, “We’re not going to the hospital this year.  We’re not.”

First a call to the group I worked for this past summer—Integrated Health Services.  Their whole mission is to keep mental health clients out of the hospitals and emergency rooms.  I know I need more support now—I’ve been hearing from my providers all year that I don’t have enough in the best of times.  I’m not sure what IHS can do, but I made an appointment for Monday with Rosario, my care coordinator, and with Allison, my peer, to sit and figure that out.  They are both kind, heart-centered women.  I feel safe going to them.  The fact that I was just able to make the appointment helped.  Doing something, anything, sometimes helps.

Daily PlanToday I will start using my Daily Plan sheet, the one I created after my partial hospitalization last spring.  It will help me focus on small goals and remember to do every day tasks that get waterlogged by the swampy emotions.

I looked at how much money I’ve spent this month and cut back to the essentials.  Today I’ll figure a budget to get me through to May (February is just the beginning.  March and April can sometimes be even worse).  I’ll try to make it something I can live with, not something that will punish me for being sick.

HenryI cleaned out my refrigerator of all the liquefying vegetables and bought a few simple groceries.  I swam at the Y.  I sat with my fading bedspread for a while and sewed a blanket stitch around the frayed edges with gentle music playing and the cats behind my head on the chair.  Henry’s belly makes a gurgling, crackling sound when he’s digesting, and I pressed my ear against his fur to listen while he slept.

My apartment is a sickroom now.  No sudden moves.  No grand expectations.  Everything deliberate and gentle.  I must tend to my sleep, get to the Y every day, maintain my journal, plan quiet visits with friends, try to eat fresh food.  I will try to keep the structure sound while the storm carries on inside.  I will treat myself as someone worthy of care and respect, as someone that I love.

Goals for the Next 30 Days: Continue to Function at 9-10

Epic Journeys

When it comes to functioning on a scale of 1-10, I’ve generally rated high.  But, there are days.

Function measures how a person gets daily tasks accomplished like getting out of bed, taking a shower, tackling chores.  General consensus of the treatment staff is that if a person is a 4 or under, they probably need to be admitted to the hospital.  Here’s what I’m doing to keep my Function score high.

  1. Attend the After-Care support group for one month.
  2. Schedule weekly appointments with my therapist
  3. Continue Daily Planning
  4. Monitor for symptoms of Lapse and put Step-up Plan in place

The After-Care group is an extension of what we did every day at the hospital.  It’s a combination of checking in and being held accountable.  There’s also a deep and unique understanding between peers.  We know the pain and the faulty thinking.  We know when to challenge someone and when to soothe.  There’s nothing like being with folks who “get it.”  But since this group is an hour away, I only committed to attending for four weeks.  Gas money only stretches so far, and I won’t dig myself into debt that way again.  I’m hoping for other options by the time July rolls around.

Weekly sessions with Megan, my therapist, is a no-brainer.  She goes on maternity leave soon, but carefully matched her cases to other therapists in the clinic to minimize our trauma.  I’m constantly amazed by her level of professionalism and the great respect she affords us.  I’ll miss her, but that won’t stop me from utilizing her sub.

Daily PlanIn treatment, we made planning an art form.  Self-monitoring, setting small goals, and marking successes kept us moving forward.  It’s easy to lose track of what’s important.  I took the sheet we filled out every day, customized it for my needs, then took it to my copy shop where they made a tear-off pad that I can carry in my writing bag.  In the morning, I rip off a page, quickly fill it out, and tape it in my journal.  This way I can see my progress and where I need to concentrate my efforts.  By keeping my daily plan, I was able to recognize the depression sooner when it came back this week and watch to see if it would turn into a lapse.  With that criteria on my daily plan, I didn’t need to guess or stew about it.  And if I lapsed, I had my Step-up plan taped to my Mind Palace, ready to be put in place.  This time the mood shifted and I didn’t need the extra measures.  It was good practice, because I will need them sometimes.Step-up Plan

Even for a planner like me, this new level of self-monitoring feels gnat’s ass-obsessive sometimes.  But, I can see how much it helps.  I can feel it.  And that’s all that matters.

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