Bipolar 2 From Inside and Out

Posts tagged ‘self-care’

The Three Kinds of Care

December is National Family Caregivers Month, so it seemed like a good time to talk about caregiving. In my view, there are three kinds of caregiving: giving care, receiving care and self-care.

Caregiving

Caregiving is not an easy task, no matter whether you’re a family member or a professional. With an uncommunicative person such as one with depression, it practically takes telepathy. At times it seems impossible to know what kind of care is needed. A hug? Encouragement? Alone time? Help with chores? A listening ear? My husband, who is my principal caregiver, does all those things for me.

One thing about caregiving that I learned from my parents is that caregivers need recognition, too. My mother took care of my father all through the years of the illness that killed him. He wasn’t mentally ill, but his physical needs were many. Once my mother came to me and asked if she was doing a good job of caring for him. Of course, I reassured her. The thing is, objectively she knew that she was meeting his needs well. She just needed to hear it from someone else. You can talk about not looking for external validation, but sometimes it’s the kind you really need.

Receiving Care

All caregivers need recognition, and the best kind comes from the person for whom they care. That’s not always possible. Many therapists find it inappropriate to get gifts from their clients (mine accepted a small plant graciously). But a simple holiday card can be a nice remembrance. Other recipients of care have something to offer their caregivers as well – simple human connection.

Certainly, those of us receiving care can be irritable or even angry about needing care, but some recognition from us can go a long way toward keeping our caregivers, well, caring. Kindness is reciprocal. I know it’s hard to remember that or to act on it.

I owe my husband – my primary caregiver – more than I can say. Without him, I wouldn’t be able to do what I can do – take care of paying the bills and work enough to keep us mostly current, for example. And I thank him, appreciate him, and do what I can for him. I try not to be greedy with his time and efforts – I know he has other things he’d rather be doing or needs to do for his own care. I know I don’t do nearly as much for him as he deserves.

Self Care

For people who have a mental illness, self-care can be difficult. We know what we should be doing, but it’s often difficult. It feels like self-care is just another chore, on top of all the other things we’re not able to do. If I can’t keep on top of laundry and dishes, how am I supposed to keep on top of showering? If I can’t manage to get out of bed for more than a couple of hours a day, how am I supposed to find time and motivation to exercise?

I know that self-care is important, but I have trouble doing it sometimes. I know I’m capable of it. I’m on my own while my husband is at work, and I managed to keep up self-care while he was out of town earlier this year. But somehow, I never seem to get beyond the very basics of self-care – eating and sleeping regularly. Never mind the manicures, shopping sprees, and bubble baths that some recommend. Those might require getting dressed, going out among people, and spending money. (Bubble baths don’t, of course, unless you count going out to get the bubble bath, which I do count. I sure don’t have any on hand.)

If you’re able to make even modest efforts toward self-care, make sure you give yourself a metaphorical pat on the back. Believe me, you’ve earned it.

The bottom line is this: No matter whether you give or receive care or care for yourself, you need and deserve recognition and appreciation.

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Self-Care and the Power of Routine

When a lot of people hear the word “routine,” they think “rut.” My opinion, though, is that routine and rut are completely different. A rut is what you get into when you have nothing else in your life but work and chores, while routine is something that provides structure to your day. Of course, a routine can become a rut, if it’s not flexible enough to make room for variety somewhere.

What I think routines are particularly good for is self-care.

Let’s consider how you develop a routine. The business concept of “time-blocking” will help.

Time-blocking is a method of scheduling that relies on dividing your day into blocks of time (duh!) for each of your tasks or activities. A businessperson might have time blocks reserved for “planning meeting,” “business lunch,” and “create spreadsheet.” They estimate how long each will take and adjust the time blocks accordingly. If their time estimates are off, they revise for the next day or week.

One of the principles of time blocking is grouping similar tasks together. For example, one might have a single time block for making phone calls or answering emails. Another one is to leave some blocks empty so they can be used for tasks that you may not have completed or blocks that had to be shifted because of having to put out fires.

You can do time-blocking on a daily or weekly paper calendar, but business books recommend using scheduling software. I like the idea of using an erasable board that you can put up on your refrigerator or in another convenient place.

How does this relate to self-care? Well, it’s a good idea to make self-care part of your routine, and time-blocking is one way to develop that routine.

The first things to schedule are good habits that help you manage your disorder. For me, these are medication, food, and sleep. I take my meds as soon as I wake up and on my way to bed. I don’t consider that a time block, more like a habit, something to check off on a mental list.

I usually wake around 7:00, unless I have a work assignment that needs to be turned in early in the morning. I usually go to bed around 9:00. I need lots of sleep.

I have a time block for lunch at 12:00 and for dinner at 6:30. I make sure to have food on hand that is easy to prepare for lunch – cheese and crackers, soup, applesauce, and so on. My husband makes dinner because he wants to make sure that I eat at least one complete meal every day.

The other important time block for me to schedule is work. I’m a gig worker, so my assignments can vary. Generally, though, I work until about 11:00 in the morning and till 4:00 or 5:00 in the afternoon. I try to make working a habit, too. It keeps me from falling too far behind if I have a day when I’m simply not able to face getting out of bed and working.

You may have noticed that there are gaps in my schedule of time blocks. These are when I fit in self-care. In the morning, I have time for checking my email and Facebook. Why are these self-care? They’re the ways I keep in touch with friends and acquaintances – the outside world in general.

In the afternoon, between work and dinner, I watch some TV, usually cooking shows, which I find comforting. After dinner, I have time with my husband to see a movie or binge-watch a favorite series. When I take my meds and go to bed, I read for about half an hour. All these are part of my self-care. A person needs to set aside time for relaxation, which is a vital part of self-care.

Sometimes, I have to set aside a time block for something else. If I have to go out somewhere, I usually schedule an hour before I have to leave. It sometimes takes me that long to shower, dress, put my hair up, and make sure I have everything I need in my purse. I know that, so that’s why I leave an hour for it. Then there’s time for whatever errand it is, or maybe lunch out on my husband’s day off.

That’s my daily schedule of time blocks. I also have a weekly set of time blocks. I try to have a first draft of my blogs done on Thursday, finish them and tag them by Friday, proofread on Saturday, and post on Sunday. This is something that’s not quite work, because I don’t get paid for it. It’s something I do for myself and I get satisfaction from it, so I think of it as a self-care activity.

I also use my Google calendar to keep track of things that need to be done monthly – bills, recycling, doctor appointments for me and my husband, deadlines for my gig work, and so on. That’s self-care too, because I suffer an unhealthy amount of stress if our finances get out of control. Reducing stress is part of keeping me on a steady course. I could use the weekly or daily functions, but those are tasks I’m used to after getting into the habit for so long.

I prefer having these times and tasks in a reasonably consistent schedule, with some room for adjustments. Routine helps me get done what I need to do and enables me to schedule self-care too, rather than leaving it to last.

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On My Own

Earlier this month, my husband went away for 11 days to visit his 96-year-old mother, leaving me at home to fend for myself. I didn’t object to his going (though that hasn’t always been the case on other occasions). But it left us both concerned about how I was going to manage without him for nearly two weeks.

My husband helps me with most of my self-care needs. I guess I shouldn’t even call it self-care because he does so much of it. He makes sure I eat regularly, shops for food, and usually prepares dinner. He recognizes when I’m overwhelmed and gives me a hug. He helps me get ready if I have to go out. He does most of the physical chores. (I do the ones involving a computer, like correspondence, bill-paying, and scheduling appointments.) He calls me twice a day to make sure I haven’t fallen and been unable to get up. If I don’t answer the phone, he rushes home on his break to help me. I really don’t know what I would do without him.

For 11 days, though, I was going to have to. We hadn’t been apart this long for years.

Since one of my major self-care problems is forgetting to eat or not having the energy to make myself something to eat, he stocked up with all the things I like that were easy to fix and eat: juice, cola, ginger ale, yogurt, cans of soup, whole wheat bread, bologna and salami, assorted kinds of cheese, applesauce, and those little frozen meals for useless people like me. There were muffins and frozen waffles for breakfast, peanut butter and mac-n-cheese and spaghetti for lunch and dinner, and even jello and pudding for dessert. Everything that needed heating was microwaveable.

I often eat in my study, where there is a little tray table, so we devised a strategy for getting to and from the refrigerators. The time when I trip and fall most often is when I’m carrying several items and lose my balance. He came up with the idea that I should carry my food items in a plastic grocery bag to and from my room. We have hundreds of those bags. And it worked. I didn’t fall once. I don’t know why we didn’t think of that before.

He still called me every day, though of course there was nothing he could do for me if I fell. In fact, he called me much more often than twice a day, just to talk. We found the thing we miss most when we’re away from each other is simply shared conversation.

I developed a little routine to see me through the days. In the morning, I would have breakfast and watch a cooking show till I was awake and alert enough to start my day. Then I would do my work in the mid-morning until lunch. After lunch, more writing. After dinner, music or TV, or more work, if I had an especially pressing assignment. Go to bed early. Lather, rinse, repeat. Repetitive, certainly, but it seemed to work.

So, what did I learn from this exercise? Well, first of all, I found out that 11 days on my own is a doable thing – if we anticipate difficulties and prep for them. That I am able to continue my daily rhythms and keep up with my work, eating, and sleeping. That I experienced no recurrence of my bipolar symptoms even though my usual environment had changed. (I had been worried about depression or anxiety setting in.) That the loss of my husband’s presence wasn’t crippling. That we managed to retain our important connection despite the physical distance between us.

That photo with this post isn’t entirely accurate, though. I didn’t meet my own needs completely on my own. My continuing self-care still required my husband’s help. But once the systems were in place, I managed. On my own.

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The Song as Self-Care

Almost six years ago, I wrote a blog post about music and its power to heal, or at least alleviate, depression. If you’ve been following this blog, you know that I’m currently in the middle of what may turn into a major depressive episode. Again, I return to thoughts of music.

I once gave my therapist a CD of the music I liked best. I had been telling her how I had been stereotyped and even ostracized for the kind of music I like best and was embarrassed to share it with others. (Okay, it was country music, or at least the style now known as Americana – not pop country.) She played snippets from several songs while I watched her not cringe at them.

It’s the music that moves me. I’ve heard a theory that the music we love and respond to when we’re in our late teens and early 20s is what we imprint on. No matter how much or what styles of music we listen to later in life, those are the tunes and songs that will move us, no matter how old we get. These were mine. Later in life I started listening to acoustic blues, light jazz, filk, and 70s oldies, but country/Americana is still what lives in me.

Right now, one of the things I’ve been feeling is emotionally constipated. And maybe it’s time to try allowing music to alleviate that logjam.

Whenever I’m really depressed, I forget how much power music holds. When I’m on an even keel, I semi-regularly throw myself “music parties.” I hole up in my study with my computer and let iTunes blast. I even sing along, though I’m a terrible singer. Sometimes my husband joins me for a while and we have guessing games. (Who’s that singing backup? Emmylou Harris. Who wrote this? No, Shel Silverstein, not Kinky Friedman.) Sometimes I look up music that resonates with Dan and download it for him.

But mostly, it is a solitary pursuit. I wrap myself up in the music and let it soothe me. Or I rock out to the music and let it energize me. Or I let the music reach inside me and pull out feelings I didn’t even know were in there. Sometimes I use the shuffle function and let it surprise me. Other times I thread a path through the songs, letting my brain tell me what to play next. (It’s one of the things I can rely on my brain for.)

Call it a way to provide myself some self-care without spending any money. Although massages and pedicures and lunches out with friends are often touted as good self-care methods, I can’t do any of those things when I’m depressed. For me, they just add extra stress – showering, getting dressed, going out among people. I love massages, but I love them when I’m feeling good, only just a bit tense. I love lunches out, but they can’t raise me out of depression. I like them better when even chicken and dumplings feels celebratory.

But at my music parties, I don’t have to deal with any of that. I can stay in my pajamas and slippers. I don’t even have to comb my hair. I can exhibit all the common habits that go with depression and not have to use spoons trying to alleviate them.

So, tonight, I believe, it’s music party time. I’ll shut off my phone. I’ll close the blinds in case I want to chair-dance and don’t want nosy neighbors to have a view. I’ll invite my husband if he wants to be there, and not worry if he doesn’t. (What I call a “party” can easily be a party of one, and most often is.) I’ll unplug my headphones from the computer so the music can fill the room, as well as my head and my heart.

And maybe next week, I’ll have something to tell my therapist about – whether it helped or not.

How Depression Sneaks Up

I had a blog post all written and ready to go. It was about my fluctuating moods and my writing, and how they affected each other. Some of what I wrote is still true. The depression I suffered during my early years and the exceedingly depressive poetry I wrote during that time allowed me to learn something about how poetry works and something more about how depression works.

I wrote about how hypomania affects my writing, and that is still true. Hypomania pushes me to do my writing, even when I don’t feel like it. In fact, at times it pushes me into doing more writing than I can probably handle. Case in point: This week I wrote three samples for a work-for-hire outfit when I should have been writing or at least outlining my WIP (Work In Progress), a sequel to the mystery I have already written and have been sending around to agents.

And last night, that’s where I hit the wall. I figured out that I have sent out about 180 or so query letters and gotten only the most minimal results – rejections that said I had an interesting premise that was not right for them. Most, though, have received plain rejections or the dreaded “no response means no.” I am now second-guessing myself and everything about the manuscript.

Last night, the depression caved in on me. I spent the night in bed, not sleeping except for nightmares, and not wanting to get up in the morning.

Because my identity is invested in being a writer, though, I did get up (late), sent a few more queries, and got to work on rewriting my blog posts, which I had determined were wretched. In the blog post that I abandoned, I had pontificated about how keeping a schedule kept me going with all the writing projects and various other work I do. 

I had also crowed about my relative stability and how that was helping me keep that schedule, which was supposed to be keeping depression at bay. I found out that I lied. The fact that I have maintained functionality for some time did absolutely nothing to prevent the depression that hit me.

Admittedly, this is probably a reactive depression, with my lack of success being the trigger. The thing is, it’s awfully difficult to tell apart from endogenous depression. In fact, I have known the first to melt into the second. At first you have a clear cause that would depress anyone, then you find it clinging to you long after what would seem to be reasonable. (This is subjective, of course. What is the “right” length of time to be depressed over 180 rejections?)

What’s left? Self-care, of course. Trying to sleep if I can, and squeezing in a nap if possible. Eat something, even if it’s only some guacamole and chips or a bowl of soup. Take my meds religiously. Try to cling to that schedule even when I don’t want to.

But the truth is, I’m running out of agents to submit to. I’m running out of energy to try. And I’m running out of the frame of mind to keep me functional. I’ll be okay, I know, but it may be a long, hard climb. 

Time Flies When You’re Bipolar

Finding stability is difficult when you have bipolar disorder. The days seem to melt into one another, either life in dense fog or life on a tightrope. You can’t remember whether you’ve eaten that day or showered that week or when you need to pay that phone bill.

And forget those lists of self-care things you should do. Contemplating even one (“go for a walk outside”) leaves me feeling defeated. It involves too many steps – getting out of bed, finding clothes, getting dressed, and then the actual walking. Most of the self-care lists contain things that are next to impossible for a truly depressed person to do (wash one dish), or too mundane to engage a manic person’s psyche (nap, complete one craft project).

For myself, I get lost in the week, since I usually measure time by weeks. What was I going to do on Thursday? Isn’t there a call I need to make this week? Do I need more groceries this week? I can also get lost in the month sometimes – Is it time to water my plant? Do a breast self-check? Pay a bill? Most of these I can handle with small nudges. Water the plant on the first day of the month. Pay a bill when I get an email or call about it.

When I worked in an office or a restaurant, there were ways to measure days. Casual Fridays were a dead give-away, for instance. But there were no weekly group meetings or, in the case of the restaurant, even specific chores or a consistent schedule for each week. I used to be able to pinpoint Thursdays because it was chicken-n-dumplings day at the Hasty Tasty.

But since COVID I no longer go out to work or to the Hasty Tasty or get dressed for work (I work in pajamas at my desk). I can sometimes tell time by my husband’s days off – Thursday and Sunday – but even that gets confusing, since I measure by when he goes into work (Wednesday, for example, and Saturday evenings) and he counts by when he gets off (Friday and Monday mornings). “Thursday into Friday” or “Sunday into Monday” is too much for my poor glitchy brain to handle.

I have better luck when I measure by my own work. I have off Thursdays and the weekend. Sometimes there is no work on a particular day, and sometimes I take on extra work on Thursdays or over the weekend, so it’s not completely reliable.

I do try to stick to a schedule when it comes to my writing, though. By Tuesday, I try to have an idea for my blogs. Wednesday I firm it up or do research, if needed. Thursday, I write a draft, since I don’t have my regular job to do. Fridays I tweak the draft. Saturdays I proofread and add tags. Sundays I publish. Mondays I check to see how well my blogs have done. Since my novel is finished, I have added doing three queries a day, first thing in the morning. And when I don’t have regular work, I try to either do research for my next novel, or write scenes that I know have to go in it somewhere, though not in order, since I don’t have an outline firmed up.

I suppose self-care encompasses going to bed. I usually get in bed by 9:00 or 10:00 and read to unwind (I know that this is not recommended, but it’s an essential part of my daily cool-down, whatever the day of the week it is). After I start to get sleepy, I take my nighttime pills and read a little more until they kick in. I usually just awake naturally, unless I have a work assignment that’s due early in the morning. Then I set an alarm.

These are the techniques I use to keep grounded in my days and weeks. When something unexpected happens, such as my husband’s days off being switched, I get back into the trap of not really knowing what day it is.

But as for self-care, I don’t schedule a massage or take up yoga or call a friend (I keep in touch on social media). It’s all I can do to get through a week at a time and be grateful for that.

 

A Sensory Self-Soothing Room

Photo from the author’s collection

Not long ago, I read in the Creativity in Therapy blog (http://creativityintherapy.com/2016/05/create-a-sensory-self-soothing-kit/) an article by Carolyn Mehlomakulu, art therapist, called “Create a Sensory Self-Soothing Kit.” The idea was that a box filled with items that engage your five senses is an excellent tool for being grounded when you need centering or self-care. The recommendations were for any five things that appeal to the senses of touch, sight, hearing, taste, and smell. I tried the exercise and came up with the following:

Touch – plush animal

Sight – amber necklace

Hearing – iPod playlist

Taste – caramel

Smell – Oolong tea

I never actually made myself such a self-comfort box, but I remember the exercise as a way to think about my senses and how nourishing them can nourish me.

Lately, though, I have acquired a room of my own and have been decorating it to suit myself. Recently, I realized that it has all the requisites of a comfort kit toolbox.

Touch – I have quite a collection of stuffed animals stashed around the room. A great many of them were gifts from my husband, who knows my history with stuffed animals (as we used to call them). Every Easter there was a new stuffed rabbit in our Easter baskets, along with the chocolate bunny and the jelly beans.

Perhaps the most important plushie in my room is named “Trauma Bunny.” My husband found her in the store he works at, squashed behind two huge bags of dog food in the pet aisle, rather than in toys where she belonged. Of course, he bought her and brought her home to me. Now she sits on my desk, guarding my headphones and cellphone, close enough for me to reach out and pat her on the head or fondle her ears.

Sight – I have furnished my room with many things I like to look at, from travel souvenirs to prints and paintings that have significance for me. Even the walls are a toasty rusty-brickish color that makes me feel warm just to look at. I also have a television, where I can watch shows that comfort me, such as ones on the Food Network. I have two windows, and the blinds are always up on at least one of them. The view isn’t terrific, but the sunshine is welcome.

Hearing – I do have iTunes on my computer, with more music than I could listen to in a week. Among the tunes are ones recorded by some of my singer/songwriter friends, as well as the well-known artists I like best, ones you don’t hear on the radio anymore. There is also instrumental music, from Vince Guaraldi to Béla Fleck, if I want something less distracting than voices and lyrics.

I also have a cat tree by the window, where my two cats love to sit or sleep. Both cats purr nicely and loudly. One of them even snores when she sleeps – daintily, but she definitely snores. (Of course, petting the cats also qualifies as touch, and watching them bathe themselves, which I find soothing, counts for sight as well.)

Taste – My husband keeps my room stocked with things he knows I like such as Cocoa Puffs. There’s always diet cola in the bottom drawer on the lefthand side of my desk. Right now there are honey-roasted peanuts in case I need a more proteinaceous snack.

I generally eat only one meal a day, and when I’m really depressed sometimes skip eating altogether. It’s good to know that there’s something here that is easy to access, requires no cooking, and meets some of my basic needs and likes.

Smell – Since I’ve transferred most of my library to an ereader, there are fewer books in my room, but most of the ones I still have are old and retain that almost-indefinable book smell – dust, paper, and some other distinctive aroma that I remember from trips to the used book store as a kid.

I also have a candle that smells like snickerdoodle cookies. I’ve never lit it, but sometimes I just pick it up for a deep sniff. Then there’s my tiny Mr. Coffee, which I use for tea, including oolong, herb tea, and possibly my favorite, the spicy smell of Constant Comment tea.

I practically live here, even though the house is fairly large and there are sensory delights in the other spaces as well. But what I have here, I recently realized, is a comfort box that’s just the size of a room.

Beautiful at the Broken Places

The Japanese have an art form or maybe a philosophy called kintsugi, which involves embracing the flawed or imperfect. Cracks or breaks in a pottery or ceramic vessel are repaired using gold dust and resin.

According to Wikipedia, “Japanese aesthetics values marks of wear by the use of an object. This can be seen as a rationale for keeping an object around even after it has broken and as a justification of kintsugi itself, highlighting the cracks and repairs as simply an event in the life of an object rather than allowing its service to end at the time of its damage or breakage.”

On December 29, I posted an essay titled “Broken” (https://wp.me/s4e9Hv-broken). In it, I described the despair and depression that finally hit me after a stressful year, one that ended with the news that my second book was not going to be published. It was an awful trigger for me, considering the amount of work and hope and myself I had already invested in the book, and how near it was to completion.

Instead, I have decided to embrace the philosophy of kintsugi. I may have been broken, but nothing says I can’t put myself back together and consider my mending an improvement. In fact, my therapist said something similar after I suffered an earlier breakdown: essentially, that I could choose what parts of myself I would restore and which I could cast aside. Recently I came across an old diary from that time. I have not yet decided whether to read it, keep it unread, or get rid of it. At any rate, I don’t think I’m strong enough to decide that now, given everything else that’s been going on. But there are other things I have decided to keep.

One of my decisions is to keep my first book, Bipolar Me, alive. It was went out of print this month, but I will be self-publishing it on Amazon. I won’t let the second book, Bipolar Us, die either. Right now I am exploring ways to make sure it will be published as a paperback as well as an ebook. It’s better than my first book, I think, and I want it to be available to people that might find help or hope in it.

To celebrate this decision, I have ordered a kintsugi-style bowl. (I can’t afford the real thing.) On the bottom will be written “My Story Isn’t Over,” which is also the motto that informs my semicolon tattoo. I will keep it near my desk, where I can see it often and let it remind me that beauty can come from the broken after all.

I also hope that the rebuild on our house, which was destroyed by a tornado, will make it more beautiful at the broken places. (The only thing that remained was the basement, so it’s really going to be all new.) At last I will have a home that I have had a hand in designing, choosing materials, and decorating. No more mismatched, hand-me-down furniture. No more rental-neutral walls and carpet. I can create my study as a place of comfort as well as work, one where my self-care items are readily available and the colors and decorations reflect a calm, steady mood. Again, it is a chance to rebuild something and make it better.

Most of all, though, I need to keep working on me. There are still cracks and breaks in my psyche that need to be repaired. It will take continued hard work and loving support rather than gold dust and resin, but I hope I can eventually convert my troubled life into a work of reclaimed art.

 

Asking for What You Need

I saw a post on a bipolar Facebook page that asked what coping mechanisms people used. There were the usual responses about self-care, which is certainly a fine coping mechanism. But it’s far from the only one.

I’ve learned any number of coping mechanisms over my years in psychotherapy. There’s “looking at how far I’ve come.” There’s “leaving the room when my anxiety gets too bad.” And there’s always one of my favorites: “petting the cat.”

But the answer I put down was “asking for what I need.”

It’s a good coping mechanism because no one can read minds. No one else knows what I need. And, short of them guessing and hoping to hit on the right thing, the only thing I can really do is ask.

I can ask my therapist whether we can work on my anxiety today. I can ask my friend to check in on me daily for a while. I can ask my husband for a hug, or alone time, or some distraction.

Of course, I don’t always know what it is that I need at any given time. At times like that, I can simply ask for things that might help or have helped in the past, like the aforementioned hug or alone time. My husband has been with me for so long and is so familiar with my bipolar disorder that he knows a number of things that are likely to help, and he can suggest them. If all else fails, he suggests I go to bed, or read, or listen to music, all things which can calm or center me. Sometimes he simply puts on my favorite movie, to help draw me out.

Closely tied to the mechanism of asking for what I need is the technique of negotiation. I may know what I want or need, but the other person may not be capable of providing it, or at least not right then. If a friend can’t take my phone call, I can suggest an alternative: Call me after 10:30 or sometime tomorrow. If I need distraction and my husband has to go to work, he can suggest that we go out to lunch the next day.

We’ve developed a shorthand for such situations. When the only thing I can do is say, “help,” he responds with, “help how?” If I can then come up with a suggestion, I do. A lot of the time he is able to provide what I need. But sometimes he just isn’t. Maybe he isn’t able to get me out of the house for lunch. So instead I say, “I need comfort food.” He usually says, “You can get that.” Or he may respond with what it is that he can do: “There’s cheese and crackers here. Will that do?”

Asking for help isn’t easy, and Lord knows negotiating for what you need isn’t either. Both take lots of practice. And there is always the possibility that another person simply cannot supply what you need. That’s where self-care comes in. I know down deep that a nap, or comfort food, or music may help me, and if no one else can provide them, I can usually do it myself.

Receiving help may not be easy, either. Asking for what you need can make you feel, well, needy. And receiving help from someone else may make you feel guilty or unworthy. But the fact is that you – all of us – need help at times and that learning how to ask for and accept help is a valuable skill. And a totally valid coping mechanism.

Permission to Be Depressed

Depression can be so riddled with guilt. Why am I not able to fake being okay? Why do I isolate when what I need is interaction?

Sometimes what I need is to give myself permission to be depressed. I have bipolar disorder 2, with a heavy depression component. It has overwhelmed me many times. I have fought against it, given in to it, tried to make compromises with it, tried to ignore it – almost any reaction you can imagine. Then I learned how to give myself permission to be depressed.

This is not quite the same as giving in to depression. It involves acknowledging that I am depressed and allowing myself to feel the feelings that I have. Of course, I don’t give myself permission to be permanently depressed. In a way, it’s more like giving myself permission to practice self-care and not to force myself to smile and bull my way past the depression. I recognize that I am depressed and do what I need to do to get through it. That may be staying in bed. It may be crying. It may be wallowing in sad music. These are things that I’m likely to do anyway when I’m depressed, but giving myself permission to do them is surprisingly freeing.

I used this technique probably for the first time when my husband and I went on a “barefoot” cruise vacation. It was something we both enjoyed and both want to do again someday.

But I knew from the beginning that depression might overtake me – probably would, at that time in my life – even while I was doing something enjoyable. Naturally, I didn’t want the depression to ruin the whole vacation, so I decided to give myself permission to do what I needed to do to cope with those feelings.

Most often, that involved retreating to my bunk for a nap. This enabled me to get away from other people when I was feeling overwhelmed and unable to socialize. Sure, I missed some of the onboard and shore activities, but I wouldn’t have enjoyed them anyway while in the metaphorical fog and darkness. I enjoyed what I could, then let myself not do what I didn’t feel up to doing. I didn’t try to make my husband stay with me and miss all the fun. There wasn’t anything he could do for me anyway. If the other passengers thought it was odd – and they did – they barely mentioned it to me. My husband told them I was tired. Seasickness was also a believable excuse.

In a way, having bipolar depression at that level is like having the flu. I feel bogged down and logy, inclined to cocoon, rest, and stay away from other people. I realize this is not always possible, but if it is, I can allow myself to do it. Fortunately, this spell of depression wasn’t so bad that it completely incapacitated me as it has at other times in my life. I was still able to feel enjoyment at some times, though not at others.

At other times, I’ve had to give myself permission to have anxiety. If a situation makes me anxious, I acknowledge that I am nervous, and do what I need to do. I can’t “think away” my anxiety, but sometimes I can get myself out of the situation at least temporarily. I do not have to sit and be anxious while people around me argue or shout at each other, one of my anxiety triggers. When I recognize how I’m feeling (which takes practice) and give myself permission to feel the way I feel, I’m better able to come up with coping mechanisms, such as leaving the room to get some fresh air or making myself a cup of tea.

You may notice that when I give myself permission to be depressed or anxious, part of my solution involves avoiding other people. That’s sometimes a hard thing to do. Isolation can certainly make depression worse, but it can sometimes also be necessary if pushing through, trying to smile, mingle, and socialize will make the depression worse in the end. And I have learned that if I try to do that, the depression comes along with me. Once a friend told me that it was like having a separate person with me, a person called Misery. Better to give myself permission to stay home and give myself some self-care.

What I can’t do is give myself permission to stay depressed or anxious. Giving myself permission is a very limited-time offer. It doesn’t work for those really lingering, midnight-dark depressions that last for weeks or months on end. Those, I have to fight. And while I’m depressed, I don’t give up on meds or therapy. Those are necessary to alleviate the depression instead of resigning myself to feeling it.

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