Showing posts with label Learning to Cope. Show all posts
Showing posts with label Learning to Cope. Show all posts

Thursday, April 3, 2008

Learning to cope with stress and mood swings of bipolar (manic and depression)

Recently, I have been feeling very very tired and easily stressed. I believe this is partly due to effect of being rather manic for some weeks prior to this and also partly because I have taken on some freelance assignments which are mentally taxing and with rather tight deadlines. I am also having to manage some other personal and family matters. These can be rather overwhelming. I just realized that I have been having more on my plates than I can managed!

I was feeling rather down for a few days as I was very very tired. I prayed daily for God's grace and strength. Thank God for His mercies and faithfulness. I am learning to cope through the following ways:

1) I look to God daily in prayers and reading of the Bible. When I feel overwhelmed and sad, I pour out my heart to the Lord in prayers. I told him of how tired I felt and how discouraged at times. Sometimes I felt a sense of uselessness and a dread to face the challenges ahead of me. I felt so weak and without strength to carry on. I am beginning to realize that these are signs that I am overly stressed and strain, and may lead to an episode of severe depression soon if not manage carefully.

I fear relapse of severe depression as they zapped me of all my energy and I can't enjoy God, the Bible, worship, my family, my church, my friends, my work, my hobbies, etc etc. Thank God that He bids us to come unto Him when we are weary and heavy laden and He will give us rest. I told the Lord my fear and pray that He may preserve me and help me to cope. I found encouragement in the singing of Psalm 130 that reminds me that I can cry unto the Lord from out of the depths I am in and He will hear and answer my prayers, and deliver me in His time. The song "Because He Lives" also brings great comfort and assurance to me. Because our Lord Jesus Christ suffered, died and arose again, and He is living and in control, and He loves me, I can face tomorrow in His strength and grace. Thank God that He can still any storm in my life! Thank God for giving me peace as I learn to cast my cares upon Him. My flesh and my heart fails, but God is the strength of my heart and my portion for ever.

2) I am learning to recognize early symptoms of being overly stressed and dangerous mood swings which may either escalate into manic or spiral down into depression. I am learning to realize the importance of not overlooking these but at the same time not to be too discouraged by these. I am learning to accept that these are part and parcel of bipolar which needs to be carefully managed. I can learn to manage it by looking to God and prayerfully using whatever helps and means available. I can still live a meaningful and useful life.

Everyone experience mood swings every now and then, but the tricky part about depression or bipolar is how to manage it and prevent as afar as possible from getting too manic or falling into severe depression. Even if I do fall into severe depression, I hope I will remember that it will pass away and I will be better again. It is hard during severe depression to remember what it is like to be well. I hope this blog and what I have written when I am well, will remind me of it.

One of the best coping strategies, suggested by professionals and patients alike, is using a mood chart to track my own episodes and symptoms. I am using a Mood Diary to keep track of my mood swings. Some charts I found to be helpful in tracking moods or lifestyles are:

a. Mood Diary (mooddiary.pdf)

b. Here is another Booklet from DBSA with some explanations and charts for Lifestyle and Mood Tracking (lifestyle-and-mood-tracking.pdf)

c. Here is a helpful tool to use for Healthy Lifestyle Tracking with the emphasize on Sleep, Nutrition, Exercise, Relaxation, Comfort and Self-Expression, Relationships (healthylife.pdf.)

3) I am taking my medication regularly. I am taking 100mg Lamictal (Lamotrigine) which is a mood stabiliser and 25mg Seroquel (Quetiapine) which is an anti-psychotic, daily. My pdoc said these will help to stabilise my mood on the longer run as I learn to manage triggering factors.

4) I am endeavouring to eat regularly and more healthily. I eat a variety of fruits and vegetables daily to get enough vitamins. I am also taking Omega-3 supplements regularly which is supposed to be helpful in stabilising mood disorders in long run.

5) I am trying hard to sleep at regular hours though I am tempted to work beyond my sleeping hours. I am learning to slow down now. I think with enough rest for my body and mind, plus healthy food for my body, it will be able to cope better with the various challenges.

6) I am making time to exercise every morning. I have not been able to continue my membership with the Women's Gym after the trial membership expired in mid-Feb because they have decided to change their opening hours. I prefer to go to the Gym in the early mornings as it helps to strengthen me for the daytime. Now, I try to go for brisk walkings whenever I can and do some simple exercise at home.

7) I am learning to cope with stress. I hate stress but I know we cannot avoid stress. Unless I learn to manage stressful situations in my life, I will always be overwhelmed by it.

I thank God for friends and family's advice and brain storming. Thank God that providentially, I need not do one of my freelance assignments which is very stressful due to its volumn as well as tight deadline. Although this mean a great loss of income, I am glad I can keep my sanity! I realized that I cannot take on freelance assignments that are too difficult and strenous, or mentally too straining and stressful, with too tight deadlines. I will burn myself out and it is not worth the money. My health is more important.

I am also learning to use a Diary to plan my time and tasks daily, set my priorities and break down difficult items into smaller and more manageable portions. I marked down dates of various appointments and deadlines of my freelance assignments, so that I don't missed them out. I list out items I need to work on daily, and I check them out whenever they are completed. There is a sense of accomplishment when I finished a small tasks.

I am learning to take one day at a time! Hard lesson to learn as I tend to do 101 things at the same time :-)

8) I am learning to plan some time either along the day or at least once a week, to take a break from my daily routine and to have some form of recreations. All work and no play, makes Jack a dull boy :-) I need some form of breaks and recreations, to recharge my batteries!

I am enjoying photography whenever I have opportunity to go out. I am also enjoying making bookmarks using the photographs I have taken and giving them to my church members and friends. These are rather therapeutic to me.

I am also learning to take short breaks throughout the day to stretch myself and take a drink, or sometimes a quick nap when I need them. These takes a lot of discipline too as I tend to be very engrossed in my tasks.

9) I am learning to open myself up and share with my family, church and friends when I am troubled or perplexed or too stress. Often others can see things more clearly than me and can help me to see things from a right perspective and manage them better. Thank God for family and friends who have helped me recently to manage some stressful and difficult situations in my life.

I am thankful for opportunities to go out for a meal with my friend or to go Prayer Meeting together. These help to break from my routines and are refreshing to me.

I am thankful for this blog where I can use like a Journal or Online Diary to express my thoughts and feelings. It is therapeutic for me to verbalise my thoughts and feelings whether they be happy or sad ones. I am glad that I can express myself in this way and need not put on a mask. And I am thankful for church friends and blogging friends who care for me and willing to read my thoughts and feelings and pray for me and encourage me, or make suggestion on how I can cope.

And I am so thankful to God to be supported by so many of you, my dear blogging friends! It is such a great blessing from God that though we may never meet on this earth, we can pray, encourage and support one another through the various challenges we face here. These are tokens of God's goodness and mercies to me, and I praise Him!

10) I am learning to recognize when my thoughts began to turn negative and eats into me. When my moods spiral down, if I don't recognize it, it will overwhelm me. My thoughts became rather negative recently and I started to feel very down for many days. Thank God for sending family, church members and blogging friends who reminded me of God, His love and mercies and ways to manage my condition. Some helped me to identify faulty or unhelpful thinking patterns or behaviours, and how to rectify them.

Thank God that my thoughts are clearer now and I am feeling so much better! I know I still need to be very prayerful and vigilant. I am comforted that the Lord has provided me with people who loved and cared for me, and also provided much help to manage my conditions. I know I must learn to look to Him and use these means for my well being.

Thanks and praise to God for His goodness and mercies in helping me to learn to cope. There is so much I am learning daily and seems to have to keep relearning some of these things, and reapply them. Thank God for grace and strength.

Thank God for His presence with me and encouragements through His Words. And thanks again to all of you for your prayers, support and encouragements.

Monday, February 18, 2008

Checking my thought patterns - Part 1

Thank God for seeing me through another day at work. I have 3 more days with this part-time job as it will end on this Friday, 22 Feb. This Thursday, 21 Feb, I am on leave to go for my follow-up with my psychiatrist, Dr Pauline Sim. I look forward to see Dr Sim as she has been very encouraging and helpful in treating my condition.

Today, I thank God for sending some reminders to me on how to manage my condition, through my friend, Grace. Grace has been very prayerful, encouraging, kind and supportive in many ways. Grace helped me to get this part-time job in her office and sometimes we do get to lunch together and have some fellowship. I thank God for that. Grace shared with me about a book she is reading recently on Cognitive Behavioural Therapy which talks about the way our thoughts affect our moods and behaviours. I am reminded through my conversation with Grace that I need to constantly be more aware of my thoughts and how they affects my moods and behaviours.

Last year when I began to try to understand depression and how best to manage it, I read about the 10 most common faulty thinking patterns that can either lead to a depressive episode or aggravate an episode. Dr David P Murray did a very excellent analysis of these 10 faulty thinking patterns in his 3rd lecture "The Condition" from the series "Depression and the Christian".

In his 4th lecture "The Causes", Dr David P Murray, said
In Lecture 3 we looked at 10 false thinking patterns which contribute to depression. It cannot be emphasised enough how vital it is to learn to recognise these unhelpful thoughts by prayerful self examination. It is also important and useful to note that some of these habits of thinking may be involuntarily absorbed or learned in early life and so may be deeply ingrained. When we feel down, or when we are stressed, these latent false thinking patterns tend to occur more frequently and tend to dominate. This can often lead to depression, worsen an existing depression, and, if persisted in, make recovery from depression so much harder. Sometimes, the Church can reinforce or add to false thinking patterns by over-emphasis on the negatives in the Bible and in people’s lives, or by setting standards of commitment which may discourage or depress those who are unable to attain them.
I do recognize that I have some of these faulty or unhelpful thinking patterns and they are more prominent during a relapse of depression. I am not sure whether they are the triggering factors or they are a result of the depression. I am still trying to recognize them and change them so that I can think more logically and biblically. I also realized that I have some character traits that may make me more prone to mood swings.

I read that it is important to be more aware or recognize these character traits or faulty/unhelpful thinking patterns, and then challenge and change them with more logical or biblical thoughts/behaviours.

Some of the character traits or faulty/unhelpful thinking patterns that I am learning to recognize are:

1) Perfectionism or Setting Unrealistic Expectations

Quite a number of people in my life have told me that they think I have very high expectations of myself and that I am some kind of a perfectionist. Actually, personally I do not see myself that way most of the time. I just want to do my level best in whatever I do. But sometimes when I think through it, I think that they have a point. I do not have high expectations of myself all the time and in every area. But in certain things, I tend to push myself rather hard without realizing it. Indirectly, I set unrealistic expectations of myself or goals that more unattainable which resulted in my being very stressed up or more prone to fail in my own eyes.

I suspect this is one reason why I felt very stressed for the first 2 days of work recently, as I was trying too hard to do a perfect job! Thank God for Anne who reminded me that I was being too hard on myself and that I should learn to commit my work to the Lord in prayers daily and just do my best. Thank God too for bro Arthur who told me not to be too discouraged over the fact that I made mistakes at time as that is part and parcel of work. So I am learning now to pray for wisdom and strength from God and just do my best, but not expect perfection of myself.

(Thank God also for bro Yew Hoong who reminded me to pace myself slowly and not over-strain, and for Grace who reminded me that I can take time off if I need to as the department is flexible with the hours. Thank God too for bro Hwee Kwan who reminded me to eat! I have to constantly remind myself to drink and get up to stretch myself sometimes as I can be very engrossed in my work and sit for hours without getting up.)

I think due to this perfectionism trait in my character, I am prone to have unhelpful/false "shoulds" thinking pattern which Pastor David P Murray explained as follows:

False “shoulds”

Our lives may be dominated by “shoulds…” or “oughts”, applied to ourselves or others. This heaps pressure on us and others to reach certain unattainable standards and causes frustration and resentment when we or others fail.

Life example: The busy mother who tries to keep as tidy and orderly a house as when there were no children is putting herself under undue pressure to reach unattainable standards.

Spiritual example: The conscientious Christian who feels that despite being responsible for meals and raising children, that she ought to be at every prayer meeting and service of worship, and also reading good books and feeling close to God.

Biblical example: Martha felt deep frustration that Mary was not fulfilling what she felt were her obligations and complained bitterly about it (Luke 10:40-42).

I realized that sometimes I do have a habit of saying "I must", "I have to", "I've got to", "I should"and "I need". Some of these statements may look reasonable as I think of them, but when put into context, they become clearly unreasonable. I read somewhere about the following:
"should" and "must" statements have little practical purpose. They usually remind us of what we are not doing and increase unnecessary guild and disappointment.

Unrealistic expectations occur when you attempt to be perfect and faultless at everything you undertake and in control of all situations.... This thinking style results in you having very little patience and tolerance with your own and other's weaknesses and bad habits. If you make a mistake or hurt someone, you will probably continue to criticise yourself long after everyone else has forgotten about it.
Reversing the habit

It found it helpful when I learn to use "I would prefer" instead of "I must" or "I would like to" instead of "I have to". When I think in terms of preferences instead of vital needs or demands, it remove a lot of pressure. In terms of work, it is helpful when I learn to think of what is reasonable rather than what is ideal. Sometimes the effort to make an 80% job into a 100% job is simply not worth the emotional strain. I need to learn to understand my limitations and to work within it. This way it will be less stressful for me and less disappointments.

This is a lesson that I will probably need to learn and relearn over and over again as the perfectionism trait or faulty "should" thinking pattern is too much a part of me. But I pray that God will enable me to pray and look to Him daily for grace to recognize and overcome these unhelpful thoughts and to learn to depend upon Him and just do my best as He enables me.

To be continued.........