Thursday, March 28, 2019

Lines Drawn and the Draft of a Safety Plan

Yesterday morning I woke up and wanted to immediately go back to bed. Reminiscent of mornings as a teenager (around the time of my diagnosis and at my lowest), I felt a strong pull toward my pillow and wanted to return to sleep as soon as physically possible. However, it turns out that it is much more difficult to ignore an energetic two year-old than it is your mom begging you to go to school. 
So I got up. 

I pulled on clothes so I could drive to daycare and then the train station. I don't think I said a real sentence until we were all packed into the car. 

I had known I was going to get right back into bed as soon as I got home. I was sure of it when my feet first left the edge of the bed and touched the floor. I was thinking about it on the drive; my body felt heavy and I was sure the only thing that could hold its weight was my mattress and bed-frame. 

I was right, of course. When I got back home I walked through the door, slid into my bed and under the blanket. I couldn't make my body small enough or my breathing slow enough. But then I was asleep. I was asleep for a long time. I think Shawn must have called me four times, every two hours, and each time I told him "Not yet, not now. Soon". 

Imagine a deep, downward curving line. Imagine plummeting, drowning, falling for a really long time while desperately searching for something to hold onto, something to halt your descent. 
That's not what yesterday was. 

Imagine instead a dash, something that looks like this "-". Sure, it's flat. But it's short, halted, directionless. Now, this may be an unpopular opinion, but I sure as hell would rather know I was going somewhere. Nine times out of ten I would choose that downward curving line over this dash, no question. 
Yesterday I did nothing, felt nothing; I barely existed and that didn't bother me at all. Everything I could have done felt like too much effort for too little reward. I didn't care. Ask anyone well acquainted with depression and they'll tell you that the not caring part is the most dangerous, because that's when it is easiest to give up and give in. 

I didn't care and I didn't see that changing anytime soon. Halted, remember? 

But then Shawn came home and whether he studied the safety plan on his train ride or he already knows it by heart I have no idea---he just poked and prodded at the dash a little bit. Extended it, gave it a little shape.

He held me for a little while. He put socks on my feet and helped me pick out shoes so that we could go on a walk with the dogs. When we got home and I collapsed on the ground because I was already so tired, he picked me up and put me in front of the kitchen sink. We cleaned the kitchen together, me doing the dishes and him cleaning the oven/stove. He kept me company while I took a bath, because I had wanted to be clean for the past two days but had been too tired to do it. 
And at the end of the night, when I looked back on what I had done, I felt something.
A little bit of hope.

For those that are curious, I want to share a little bit about my safety plan. I decided to divide my safety plan by the different states of my mental illness: anxiety (which is not part of my bipolar disorder but relevant to my particular experience), mania and depression. Under each of those emotional states I outlined three categories: 
1. signs (symptoms/behaviors that characterize the specific emotional state), 
2. options (or you could call this category coping strategies, things I do both before and during the emotional state to address it); 
3. and things that Shawn can do (ways he can help support me in coping/addressing the emotional state).
Under each category I listed four items, although I'm sure I could come up with more, to keep the safety plan specific and accessible. I didn't want Shawn to get bogged down with details that might make it more overwhelming to read or that create more questions than answers. 
At the very bottom, I made some notes about items I had included that I thought needed some extra context. For example, one of the ways I have included that Shawn can support me with my depression is to ask me about my medication. I realize that without context, it may appear as though I am requesting that Shawn ask me whether or not I have taken my meds. However, I am often frustrated by that question because it seems to imply that medication is the solution, that depression can be prevented if I take my medication as prescribed and challenges my commitment to my mental health. I have been committed to taking my medication for at least four years now and believe that it is an important part of my treatment plan. Instead, I suggest in my safety plan that Shawn ask me how I feel about my meds effectiveness and remind me that I can reach out to my psychiatrist to increase my dosage, if I feel it is necessary to do so. 

After drafting my safety plan (in a shared iphone note), I went through it in its entirety with Shawn, explaining it point by point and giving him an opportunity to ask questions. As we read over the draft together, Shawn added any notes to items he had asked for clarity around. 
To be clear, this safety plan is to help address an emotional state in its early stages and to monitor it throughout. The hope is that these strategies will prevent me from experiencing a "mental health crisis". Throughout this plan, the first item listed under ways for Shawn to support me is to check that I am safe. This means that I don't have a plan to harm myself or others. I have not reached this point in a very long time and don't expect that with my current treatment plan I will, but I think it is one of the most important questions a loved one can ask me when I am in any of these three emotional states. If my answer is no, I need them to know how to help me.
The details of this part of my plan are still in the works. They are more complex and will take time.  

I am still learning how to let my partner support me, it's a lot harder than you'd think. But I feel good about the work Shawn and I have done so far. 
Last night, I saw the result of that work. And this morning I woke up feeling something.

Tuesday, March 26, 2019

Here and Back Again

I'm not sure where to begin this time, although I guess I never really am. I want to say I'm back here, back on the blog, back to depression. Usually my return to writing is a good indicator of my current emotional state. Something I'm struggling with though, is the feeling that the place I'm currently in appears to be familiar and brand-spanking new at the same time.

I'm depressed; I cried it out, I've leaned into it (after some kicking and screaming--wouldn't say embraced, exactly), I'm calling it what it is. I'm depressed and yet I feel like a different person. My beast wants to pull out all of the old stops but none of it is sticking. I didn't see it coming this time and I definitely shamed myself for missing the signs (you'd think that over a decade of experience with depression would be good for something) but I'm starting to think that I wouldn't recognize it at first if my beast had smacked me across the face with it. It's depression alright, but it's a whole new shape and color. And a whole new me has risen to meet it. 

I am living in a new place.
I am in a new relationship.
I am helping to raise my partner's son. 
I am unemployed and anxiously awaiting the start of grad school.

I am also depressed.

I'd be lying if I said I hadn't hoped to leave my beast on the other side of the country, to set him on fire so that after graduating from undergrad, bringing closure to relationships and grieving the loss of my grandmother, I could arrive in Rhode Island born anew. And I'd be lying if I said that I know how to navigate the introductions: my beast to my new little family and my beast to myself. 

But I've started. 
I named this (depression) on Saturday. 
On Sunday I went for a hike with my partner and our dogs and I felt my brain settle in my skull, my heart and lungs cling to my rib-cage, my muscles to my flesh. I was anchored in my body and it felt different.
I called my psychiatrist on Monday (like I said I would) and we made the decision to increase my medication for the time being.
Later (still Monday) I wrote a safety plan for myself and my partner. I described worst case scenarios, took responsibility, and asked for help. I extended myself farther than I thought myself capable of, sitting in vulnerability longer than I prepared myself for and waited for rejection that didn't come. Then, before I could catch my breath I rose to meet parenting and an inconsolable two year-old at his bedroom door. I held him in his vulnerability, ran my fingers through his hair, sang to him. This too, felt different.
Today is Tuesday. And you could say I'm back here. But what does that really mean anyway?