The last time I was hospitalised, one of the projects that we were most encouraged to work on in our group therapy program was a "plan" for being ill.
This sounds a bit depressing at first, but to me it's a way to utilise the DBT technique of Radical Acceptance - radically accepting that I do suffer from mental illness and that I will become unwell from time to time and that it's my responsibility to do my best to manage this.
The first part of the plan was to come up with a list of Warning Signs - these are the thoughts or behaviours you notice yourself exhibiting when you're becoming unwell. Here are mine!
As my symptoms might be triggering, I'll indicate where this starts and ends if anyone would prefer to skip this. (Thanks to Debbie at Healing From BPD, my favourite blog ever, for this idea.)
My sleep will become of very poor quality, with frequent waking and some scary dreams, but I'll continue to spend huge amounts of time in bed.
2. Social Isolation
I'll start saying No to everything. Leaving the house becomes harder and harder.
Oh yeah, I become irritable as all get out! Nothing is too small to tick me off when my mood is worsening. Friends, my parents, the cat.. everyone gets some nasty words.
--- TRIGGER WARNING ---
Eating becomes a minefield, because I'll either stop for anywhere from one to three days, and/or then binge uncontrollably. For anyone wondering, this is a terrible idea for weight loss! Your body thinks it's starving and so the OPPOSITE occurs. I'm just saying.
5. Self Harm
For me, I cut my upper right leg when there's too much inside. (This never used to happen before I met a person who was not very nice. But I've already covered enough about them!)
6. Alcohol Abuse
During a time when my condition is not going so well, it's far more likely that I'll challenge my body to a drinking contest. I notice that I am actively trying to dull my feelings or distract myself from them when I do this.
7. Suicidal Ideation
I just start thinking about it a lot. Not much more to say.
8. Suicidal Plans
For me, there's a noticeable difference between thinking about it and really thinking about it.
--- END TRIGGER WARNING ---
Did you like the little rainbow colours of increasing craziness? :)
The second part of the plan is to have a clear idea of what steps to take when these Warning Signs show up.
For me, it boils down to:
- Telling a friend or parent that I'm not doing so well.
- Telling my Psychiatrist, Psychologist or GP that I'm not doing so well.
- Telling a Mental Health Crisis Team that I need help.
This way I can pick a response that I think suits the signals I'm giving myself. I guess it could depend on how long I've been noticing a difference, or how strong my symptoms are.
In any case, although it seems like obvious stuff, I find it helps to have it written down.