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December 21, 2006

Personal accountability in mental health

For the past couple of days I have been thinking of the issue of personal accountability in mental health. When we think of our emotional well-being, we probably often think of many factors--what our triggers are, our history, past experiences. How often do we think of the role we have played in our own emotional well-being?

It's often much easier to blame circumstance or other people for triggering the feelings that we have inside--the driver on the road who cuts you off because she's talking on her cell phone, or your narcissistic mother who contrives to ruin every holiday. How often do we take stock of our reactions to circumstance or other people?

Let's discuss self-sabotage for a moment. When we think of working out issues in therapy, for many people it often means untangling the lines of smudged boundaries and chaotic emotions, and in particular it often means working out interpersonal relationships. I have been in abusive relationships and my first inclination is to talk to my counselor about how poorly I was treated and to have my feelings of being wronged validated. There's another step in the recovery process though, and that step is acknowledging that I play a role in the abuse. If I refuse to set and maintain appropriate boundaries in my personal relationships, then in a sense I am not adequately protecting myself and continue a pattern of inviting toxicity into my life. If I change the cycle by erecting and defending those boundaries, then I have become an active participant in my emotional health by accepting personal accountability. If I continue to justify helplessness or rationalize it, I will continue in the cycle.

I can think of few people who would relish the thought of hashing out their own self-sabotage--it takes some courage, some internal strength, and some self-esteem to stop trying to protect yourself long enough to allow yourself to heal and grow. Defense mechanisms are probably one of the biggest walls between a person and healing. Some walls are good, they serve as boundaries to protect our intimate selves, but some walls are counter-productive and rather than protective, they are isolating, divisive.

Dealing with toxic inter-personal relationships is a riot of defenses, walls, gnarled coping mechanisms, ambivalence, fear, and denial. We often have several choices of paths to take towards personal progress. Accepting our own personal role in our mental health (anger management and depression come immediately to mind) is not always one of the first things we think of when we think of getting well, especially if we are battling with family or friends who seem to make everything our fault. It is, however, often a large contributing factor to the tangle.

In an effort to feel better, many of us push back on the world around us to try to avoid the toll on self-esteem that accompanies acknowledgment of a mistake. We make our problems someone else's fault, rationalize our behavior, and cite other people or circumstances as justification for our own errors in judgment. In this world, two wrongs make a right.

While in the moment it may feel like a relief to absolve oneself of guilt, in the long-run it may sabotage your long-term efforts to recover mental balance. If you continually suffer from depression and feel like you get nowhere in therapy, perhaps it's time to examine whether you are hitting a wall because you are denying yourself personal accountability for your own health. Sometimes sheltering yourself from the accountability really means sheltering yourself from personal truths, meaning that you never learn the lessons you need to learn in order to make progress and move forward in life.

Of course, avoiding self-sabotage doesn't mean owning other peoples' emotional baggage or problems. It's entirely possible that your mother is a narcissistic person who does truly ruin family events in which she participates. It's up to you to decide not to permit the opportunity, or not to respond in a way that maximizes the negative impact. It's possible to swing too far in the personal accountability category, owning everything, martyring oneself. I personally see this as an act of passive aggression most of the time, but sometimes it's a sign of severe lack of self esteem. Working through these issues with an open mind and the help of a qualified mental health professional is key.

Posted by lunasmom at 12:57 AM | Comments (0) | TrackBack

December 11, 2006

Children explore the world, you should too

The other day my son and I were in our living room, he was playing a game and I was doing homework for a class I am taking online. He stopped his game and stood in the middle of the room, waving an arm in front of him, with a slight frown on his face. He yelled "SHOO!" while he waved vigorously, interrupting my concentration and causing me to take notice of his peculiar behavior. As I was about to ask him just what he was doing, he shrilly asked me, in a slightly perplexed and yet exasperated tone "MAMA, what IS it?"

Well, I was getting a little concerned now, since I didn't actually SEE anything, so I stood up and walked around behind him to try to see from his perspective. That's when I figured out what "it" was.

I laughed as I turned to him and exclaimed "It's a sunbeam!" It was, in fact, three sunbeams with about a million motes of dust dancing in its light. They traveled the long distance from the small, high windows in our front door, angling in across the length of the living room and coming to rest out of his line of sight, on his pant leg and the floor behind him. He could see the dust, and to him it must have seemed ghostly, but he couldn't disperse it which he found slightly distressing.

His response? He looked at the ghostly light again. His gaze traveled its length to his pant leg, where he could see the bright beam come to rest. A mischievous grin spread across his little face and he said "OH! It IS a sunbeam. ... I LOVE sunbeams!" and then he proceeded to jump in and out of the sunbeams until he remembered his game and ran laughing and screaming from the room.

My lesson learned?

1) Stop to see things from your child's perspective and you will see things you couldn't see before.

2) Take the time to experience new things and explore the world with your children.

3) Don't be afraid of a few sunbeams.

Posted by lunasmom at 4:33 PM | Comments (0) | TrackBack

Balancing activity to combat mood swings

Have you ever slept too long or late in the day and awakened feeling worse than when you went down for sleep? Maybe you wake up with a headache and just a touch of lethargy. For people who struggle with mood swings or depression, these kinds of sleep overdoses can actually trigger low-grade depressive episodes.

It's not just sleep either. Periods of fluctuating levels of activity can trigger cycles in mood. I have been sick with pregnancy hormones for the past few weeks and during that time I experienced a lull in work. Because I was feeling unwell, my husband took over chores that I would normally perform as well and I ended up on a type of unexpected bed rest. At first, the break from responsibility was a much needed stress relief but soon it actually became a source of stress.

Imposed inactivity can trigger low-grade depression, much like oversleeping can. The lack of structure and guidance, anxiety about whether the lull will lift, lethargy from inactivity, and maybe stress from guilty feelings of "I should be DOING something" can all work their way up to feelings of depression.

Balancing your activity levels is important for balancing your moods; even if you are on restricted activity, there are things you can do to help create balance in your day. My tips, based on my experience from the past few weeks:

1) Communicate with everyone in your household. Let them know what is going on with you, particularly schedule-wise. If you are put on medical restrictions and are out of work, temporarily disabled, or permanently disabled, make sure your family understands what that means--hey, make sure YOU understand what that means. Let your doctor do the diagnosing and the talking and explaining so you and your family are all on the same page and have the same idea of timeframe and activity level. Doing this will help you let go of feelings of stress and guilt that somehow you should be doing more; if you stick to exactly what you are allowed to do and feel up to, and your family has reasonable expectations, then you should not feel guilt.

2) If you are going through a period of inactivity due to a lull in work, being between projects or jobs, etc. then your first steps should be to communicate to the appropriate employment organizations to make sure they know you are looking for work. When I get downtime at work, the first thing I do is let my boss know that I have downtime and when I expect to get my next project in. By doing this, he can coordinate my time with the rest of the department and if someone else is swamped, I can lend a hand. Also, if there's truly no work, I've notified the appropriate authority of where I stand so I don't have to be worried that somehow I am goofing off. Everyone needs a break sometimes, too. Then, once I have communicated with my boss (or unemployment office, or temp agency, etc.) I can communicate with my family to let them know what my schedule is looking like and discuss ways to spend that time. It's okay to schedule some time just for you to do nothing, but my point here is too much nothing can be a bad thing, so communicating with family will help you plan your downtime so you can have a break but maintain forward momentum too. It's also so that people understand the impermanence of your situation--maybe you won't always be able to go out for an afternoon walk with the dogs, or pick up the kids from school, but right now you can, so you will. Keep the surprises and unpredictability to as low a level as you can, this will help you stick to routines and adapt them as needed and maintain the structure your family needs to function well.

3) If you need a rest, take only the rest you need. If you're on bed rest, find out exactly what activity is restricted and what is not and make a plan to fill your days with as much activity as you are permitted. If you can only get out of bed to shower and pee, make sure you get your shower and have someone bring the world to you! Keep a schedule. Include friends and family--bed rest can be isolating, medical restrictions on activity can be isolating, find ways to stay connected. Get a cordless phone and schedule an evening chat time with your best friend, sibling, whomever.
Connect the computer in your bedroom. Take an online class, do something creative, plan for a holiday. Find fun ways to take the monotony out of your day and ask for your friends and family to help. Set goals and meet them, you'd be surprised all the things you can do from bed.

4) If you're already depressed because you're out of work or sick, keeping a schedule is even more important. Schedule yourself for basic activities--wake up, take a shower, get dressed, make breakfast. The simple act of getting clean and putting on clothes makes it easier to make the next step to "pick up milk at the store. stop at library on the way. talk to neighbor." Work up to "get dressed" by first doing "wash clothes" if you must, but make sure you work on those basic daily functions because they set the foundation for your day.

5) Keep connected to yourself and your family. Make sure you're doing your minimum and check in with your family, job, or doctor if you are worried you aren't or if you feel you can do more. Benchmark your progress realistically and not through the distorted lenses of depression so you can accurately assess where you are, where you want or need to be, and how to get there. Some people need more activity than others and it's a fine line between active and overwhelmed. Constant assessing from day to day will help you keep your head above water or break the surface if you need to. Some days will be better than others, energy levels sometimes fluctuate, and that's ok. Just try to keep on track and you can make up and even out over a period of time.

Posted by lunasmom at 3:58 PM | Comments (0) | TrackBack