Coping Mechanisms and Wellness Strategies

I am neither condoning nor condemning the use of recreational drugs like alcohol and marijuana, but my psych made a very astute observation on the matter of self-medicating. She said that it is harmful to self-medicate, but it is very much better than the alternative when one is in a desperate state. If it stops a desperate act from happening, it's okay in my book.

Short term, self-medicating can be a life saver. Longer term, it can be a huge hindrance to overcoming one's mental health issues, and can in fact actively contribute to those issues.

People with known addictive personalities or a history of addiction in their families should be especially cautious when contemplating self-medicating.

Qualified members of one's mental health team - GP, psych, pdoc and/or counsellor - are there to help you help yourself to get better. This therapeutic relationship works best when it is an active partnership between yourself and them. If you see your psych as an authority figure, don't fully trust them, or do not have confidence in them, then that is restricting your openness with them.

Maybe you hold some things back because you worry you will disappoint or concern them. Perhaps it's something unpalatable about yourself that you are not proud of, and so cannot bring yourself to the point of revealing your "dirty little secret". It could even be that you don't consider a particular mood or thought or event important enough to discuss with them. Perhaps you are too afraid to "go there" with whatever deep-seated trauma you are grappling with.

All of these things are obstacles to you getting better, because they limit your ability to disclose information about what is troubling you. Consequently, they limit your psych's ability to help you.

From my own experience, if I hold back in therapy for any reason, then I am basically doing the equivalent of going in for surgery, but tying my surgeon's hands behind his back before the operation. My psych needs to know as much as possible about my moods and thoughts and concerns and state of mind and life events in order to best be able to help me. They can only know this if I am wide open and brutally honest.

Of course, my approach to therapy is not everyone's cup of tea. It can be very very painful and intense for me. I get a lot out of being uncompromisingly hard on myself when doing therapy - either self-therapy or guided by a psych - and try to get rid of all those little lies and half-truths one tells oneself so many times that one really starts to believe them. Self deception can be a valuable self-defence mechanism at times when one is intensely vulnerable, but it can also be a huge hindrance to ongoing progress in therapy.

Therapy is as individual as we are. Some people who seek therapy respond very well to the vaguely unstructured "chat" style where they talk about what's going on in their life and what's troubling them. Just expressing those issues verbally to someone else is a very powerful thing. This therapy technique can also be good for diving deeper into the analysis of one's issues.

Others respond well to structured therapy such as CBT or Schema therapy. Alas I cannot comment on this, as both psychs I have seen were "chatty". I imagine that these therapy styles are much more focused for specific issues and ongoing destructive patterns in one's life.

Finding the mix of therapies (and the right therapists) that work best for you is crucial to ensure the best possible quality of life for you. If you engage your mental health team as partners working together for a common goal - your improved mental health - then you are giving yourself the best chance possible of reaching that goal.

One of my biggest problems living with bipolar is that I often take life too seriously. Everything is lived on the bipolar extreme... it's all so intense and in your face. Every little inconsequential interaction with someone is the make and break of your emotional world. A wrong consultant in your Centrelink interview can result in Tolstoy's War And Peace of suffering. The ignorance that others have of the amazing depths and breadths of what you emotionally invest in everything you do is a mortal slight, the proverbial removal of your heart from your chest with a chainsaw.

As bipolar sufferers, we need to realise this emotional intensity of ours, accept it, roll with it, and minimise the damage it causes to ourselves and those around us. Yes - everything we do is invested in emotional energy strong enough to scare off most "sane" people. And with good reason. Our lives are intense. We often career from extreme to extreme, and the collateral damage can be huge.

It's at times when life is most "real" for us that we need to take a step back and take life a little less seriously. Otherwise we risk getting caught up in our emotional storms and losing it totally. Been there, done that...

I guess it's all about finding a workable balance. Too serious and intense, and you end up with everyone running from you. Too light and fluffy, and you end up being a reality TV caricature of a real person...

I've driven myself into deep depressions in my life on numerous occasions, and it has all been as a result of seeing the wrongs in the world and yet being largely helpless to do anything about them. I then ruminate on those ills, and my impotent rage starts to bubble. The next step in my decline is usually a deep resignation and helplessness once the rage passes, and I arrive at my usual spot in the bottom of the pit. Heck, I've been down in that pit so often that there's a reserved sign and valet parking for me...

I have found that this pattern is part of my disorder - a super-strong value set, combined with a hypersensitive nature. Add a pinch of bipolar, and the recipe for disaster is complete...

If possible, I need to try and find ways to stop this cycle from repeating quite so periodically and quite so extremely. It is detrimental to me, with emphasis on the mental...

When I am connected to my inner hippie, I realise one of the fundamental truths, certainly of my life... we are born unto joy. Anyone who has looked into the eyes of a happily gurgling babe will know this self-evident truth. The light of joy in their eyes fairly shines out of them.

Alas, from this innocent and enlightened beginning, most of us spend our whole lives walking away, turning our backs to, and otherwise forgetting our deep and natural connection with this inner joy.

I want to take a moment to highlight the difference between joy and happiness. Happiness is fleeting - a mercurial moment of pleasure that lights up our lives. But many a life has been ruined in the false belief that happiness can be bought, or that it will last forever. Despair is often the reward for this temporary mirage that is but a pale shimmering reflection of the joy within.

Despite our lifetimes spent distancing ourselves from our inner joy - our natural state - it can never die. It is never destroyed, for joy is eternal. It waits within the deepest recesses of our being for us to find our way back to it. Joy is the source of happiness and of love and of empathy and all the other great and noble things within the human spirit, the wellspring from which they flow. The waters of this well run deep and pure.

No matter how deep and profound our depression is, no matter how lost in utter despair and mired in total hopelessness we are, no matter how thrown around by our emotions we are, no matter how dead our dissociation makes us feel inside, no matter how afraid and alone we are, our joy waits within us for us to find our way back to it, always and ever there.

I use the term "joy" to describe this natural inner state of our spirits. People of faith would perhaps refer to it as the love of God. Whatever label we attach to it is ultimately unimportant. What matters is that we have a belief in this ineffable and undying thing within. Such a belief is all the more important when we are lost and lonely and broken and far from the warmth and light of our joy. In the long cold night, even the memory or fantasy of the warming fire can help to lessen our current pain and suffering.

Buddhists know of the joy within. It is not associated with material pursuits or the seeking of temporary pleasures or satisfaction of our hedonistic urges, though many confuse the temporary feelings they get from this with true joy. Joy is also not to be found in hypomania or mania. Bummer...

Joy is pure and transcendent. We attain to it when enlightenment is reached. Few people ever get to true enlightenment, but even the briefest glimpse of our inner joy can be enough to see us through our darkest hours.

To all those out there, suffering under the burden of your horrific pain, I would humbly suggest that you become seekers. Search within for that joy, that light, that love. When you find traces of it, be heartened and continue to seek. Do not despair if you are unable to see even a trace of it, for it is there within, waiting for you to find your way back to it.

Each and every lost and suffering person in this world deserves to find their way to the natural state of joy from within.

Being able to identify your moods and whether you are heading for a big high/low is an important part of one's coping mechanisms. I believe it is possible to avert major highs and lows by getting in quick and being aware of how you're travelling, before it's too late.

Having a trusted friend or a loved one who knows you well is a huge advantage in my experience. They can gently tap you on the shoulder and say "Erm... Si... why are you standing naked on your balcony with your privates painted green?"

Failing that, keeping a regular or at least semi-regular mood diary can help heaps. It has helped train me to be more aware of the ebbs and flows of my moods, and which early warning signs to be aware of. In my experience, the sooner you identify you are heading too high or too low and get to applying your coping mechanisms or wellness strategies, the better. Early intervention can sometimes save a lot of pain.

Everyone is different, but some warning signs may be:

• Increasing frustration levels
• Noticeable changes to sleep patterns
• Heightened senses - crisper eyesight, scent awareness, hearing sensitivity, taste explosions in your mouth, touch sensitivity
• Heightened sensitivity to music
• Unusual and inappropriate moods
• Excessive horniness and hypersexuality
• A desire to take on multiple challenging projects simultaneously.

A lot of these things aren't necessarily bad - hey, we all love a controllable high - but they have the potential to get out of control mighty fast, and so any early warning signs are worth their weight in gold.

For me, changes in my sleep patterns is often a strong indicator of changes in my bipolar mood cycle. When I'm depressed, I usually oversleep a lot - minimum 10-14 hours per day of sleeping and/or napping, interspersed with occasional flareups of insomnia. When I'm hypomanic, my natural tendency is to get about 3-6 hours sleep per night, and sometimes to skip sleep totally for a day. Getting to sleep can be very difficult because of the elevated mood and energy levels.

Many sufferers and researchers stress how important regular hours of quality sleep are in helping to regulate the wilder swings of bipolar. Regular sleep can take the extremes out of the ups and downs, and even avert full-blown episodes of depression and (hypo)mania. This has certainly been my experience.

The difficult part is applying our wellness strategies to try and regulate our sleep patterns. Eight hours a night (or whatever one's normal sleep requirements are) is a piece of cake when we are level and "normal" in our cycle.

When we are depressed, the physical and mental exhaustion can be severe, and it is so very difficult to try and force ourselves to get out of bed. But even just a slow walk around in the house can help. A sit-down in the garden with some fresh air and sunlight can do wonders too. Any physical activity will help, as it improves circulation, oxygen absorption and the production and/or proper regulation of energising brain chemicals. Willpower is often needed to break through the wall and force ourselves to do that which we least want to do. But believe me, it's worth the effort.

When we are (hypo)manic, the elevated physical and mental energy levels can also be very severe. Trying to slow down is nearly impossible, as we are swept away in multiple storms of enthusiasm, taking on multiple projects, awash with creative energy, vibrant thought, sensual stimulation and intimate connection with the infinite possibilities of the universe. Trying to rein in (hypo)mania's fiercely galloping horse can be every bit as difficult as flogging depression's dead horse. To try and force yourself to slow down is to invite a deep and damaging frustration and irritation that can quickly build to anger. This energy will not be denied. Once again, this is where physical activity can come to the rescue. Robust exercise can help to dissipate the physical energy, and once again regulate the balance of one's brain chemicals.

Over the past 3 years, I have had reasonable and growing success in averting disastrous highs and lows, and I believe that the regulation of my sleep patterns has been a major contributor. I must confess that I am not doing enough regular exercise - I need to be more disciplined in this regard. I feel that the extremes of my bipolar cycle would be even further moderated if I challenge my sometimes sedentary lifestyle.

Despite struggling a lot with depression through the years, I somehow managed to muddle my way through high school and an engineering degree at uni. But it was tough, and my mental health was definitely affected.

I was only officially diagnosed with depression and then bipolar a few years ago. I've been in the work force for 23 years now, and after my diagnoses, I went back through that working life and identified an ongoing pattern of me taking on too much with my work, followed by a spectacular bunch of stellar achievements, followed by a bone-crunching crash into a major depression lasting anywhere from 6 months to 2 years. I did this again and again.

This pattern is so obvious to me now, but whilst I was ignorantly living it, it was all I could do to survive it. Each time, I was setting myself up for failure by dangerously exceeding my capabilities, and the resulting crashes were devastating to say the least. It would take months and months to try and put this humpty dumpty together again...

And so, here I am now. My last major depression was the worst one ever - it lasted 2 years, with a 6 month stretch where i hardly got out of bed. Then my wife left me, and it got much worse before it got better.

I've been mostly unemployed for about 2 years, and underemployed for about 3 years before that. Slowly but surely, I am coming to grips with the fact that I have limitations that most "normal" people don't, and if I exceed those limitations for too long or too often, then I'm going to crash and burn. This has been a very difficult thing to realise. It has been a severe hit to my ego. But I can't let pride stop me changing my life for the better, and I have to accept certain painful realities about what I can and can't do.

Learning to live a quality life within one's limitations is difficult but very possible. In fact, I would say it's absolutely crucial for our continued mental health. Living within my limitations does not mean that I'm resigning myself to being a gimp chained in someone's basement for the rest of my life. I can lead a full and happy and rewarding life. I just need to be more aware of taking on too much, and I need to find ways of challenging myself and of contributing in a meaningful way, without setting myself up for failure by triggering myself into depression after depression.

There are no easy answers, because people with mental health issues struggle to fit into society. I don't believe the problem is so much with us as it is as a result of the inflexibility of society. But it is possible for us to live balanced and full lives within the confines of our society. Learning more about our limitations, and how to effectively use our strengths and avoid life situations where our limitations are exceeded too often is key to our success.

People with mental health issues struggle very much to fit into a society that is often too inflexible to accommodate our particular needs, strengths and weaknesses. Since our capacity to change society is limited, we have to look to building up a number of practical wellness strategies and coping mechanisms that gives us the best possible chance of living well within the confines of the society we are stuck with.

I grew up in a rural small-town and village environment. I was born in a small seaport town in Denmark, and when I was 4, we moved to a village with about 14 houses, no shops, no nothing. I struggle with cities and all of the stereotypical issues with them - the rudeness, the superficiality, the lack of care and community. I believe, though, that part of this is genuine reality, and the other part is my own perception of "city folk" that I project onto them. Being aware of this, I try to avoid sweeping generalisations, though they are often very tempting terms to think in.

My natural preference is for regional areas rather than cities. There is just too much rush and hurry and stress for me in city environments. There is also a depersonalising tendency with just having so many people around. I stay away from cities as much as I can. I don't like the stress, the sensory overload or the pollution. Having said that, I spent about 9 months living in London, and in amongst all of the rush and stress, I found very genuine and kind people wherever I was able to get a peek below the surface. I imagine the same is true of every place, regardless of whether it be urban or rural.

Them "city folk" are not the same as me, nor am I the same as them - otherwise we'd most likely all be living in the same social construct. A number of those city folk probably have certain stereotypical views about me. But if one strips the stereotypes away, maybe there is a truth underlying it all - I like to think that people are people no matter where they choose to live. Superficially different, maybe even different in certain core ways, but fundamentally the same. I don't think it is possible to draw an ethical and moral boundary at the city limits.

I have often been triggered by the wrongs that I perceive with society. Many negative aspects of society used to trigger me terribly, and I would feel this impotent rage build up about it all. Alas, because I was unable to change anything about it, I would eventually fall into a deep depression, and isolate myself.

This was not a healthy pattern for me. I wish I could say that I have found a solution to my issues regarding society, but I have not. Instead, I have chosen selective isolation. I have slowly but surely been moving further and further away from cities, and now travel around in a motorhome. The slower pace, the fewer people, the calmer general demeanour of the people - all these things contribute to reduce the potential stressors that could trigger me.

Another part of my selective isolation is that I do not listen to, watch or read news or current affairs of any kind. I haven't for over 4 years. This has been a major breakthrough for me - I avoid it like the plague, because those bastards focus 95% or more of their stories on negative crap that I can't change for the better, so why the hell torment me about it and rub my nose in it? Avoiding news has definitely made me more stable and happy. Didn't they do away with the bearers of bad news back in ancient times? It's a pity that that particular custom fell out of favour…

A third part of my selective isolation is avoidance of traffic as much as possible. Traffic, driving and public transport trigger me. I don't know what it is about it, but driving and public transport seem to bring out the worst and most selfish aspects of people. I hate being confronted by it, it is a major trigger of mine that brings me down very badly, and so I avoid it whenever possible. Walking or riding a bike is so much better - it is slow enough so you can enjoy your surroundings instead of whizzing past, and my experience has been that walkers and bike riders are generally happy and polite people who greet each other, whereas drivers and commuters are generally annoyed and grumpy and irritable.

I try to make a difference in my community, however small. This can be as simple and clichéd as saying hello to a homeless person, helping an elderly person cross the street, holding the door open for the person behind you, and showing common courtesy and politeness. My belief is that a kind act will positively affect others, and then they will be more inclined to share kind acts with others too. It's sort of like the "paying it forward" theory on a micro scale.

I see what I do on mental health forums as a way of helping a community as well. I try to share my experiences in the hope that someone somewhere will get something of worth out of it that they can apply to their own lives. This makes me feel good, and is a positive wellness strategy for me. Despite being online contact - which can never replace really real world contact - it is still an important way to avoid total isolation.

Another wellness strategy that has worked for me is to never stop questioning my beliefs. The day I think I know everything is the day that my brain dies. I try to always challenge and question my world view, my philosophies, my beliefs and my behaviour patterns. Sometimes, I fall into rigid thinking, and it can take me a while to realise this. I hold the view that I should build my beliefs as a house of cards, and then start whistling…

One of the greatest lessons I have learned so far in staving off depression is to fight that urge to crawl into my cave and hide. I fight it with every fibre of my being, every last little bit of puny strength I have as the Black Dog sinks its fangs into my flesh.

Early detection of moods is critical. The sooner you feel yourself heading up or down, the more aware you are of your moods, the better. Better to apply what wellness strategies you have sooner rather than later. Timing is critical. Wait too long, and you're almost guaranteed to be too sapped of energy by depression or too distracted and frustrated and grandiose from (hypo)mania or too caught in the gut-wrenching throes of anxiety to be able to apply those strategies effectively.

Self denial and lack of self awareness are your enemies. Be aware. Accept that your moods can tilt from polar opposite to polar opposite, sometimes with no rhyme or reason. Don't beat yourself up about this and get entangled in the heavy burden of guilt for something that is not your fault. Train your awareness and become delightfully sensitive to your thoughts and to your moods, because a stitch in time saves more than nine when mental health is the garment being mended.

One of the greatest and most difficult wellness strategies I know is to reach out to others when you're struggling. Every fiber of your being wants to hide away in your own personal shitstorm of pain. You don't want to burden others, you don't want to scare off friends and family with this broken horrid thing that is you, and a lot of the time you just don't feel capable of slapping on the mask or pretending you're human enough to interact with others. Your energy levels, ability to concentrate or skyrocketing fear may be almost insurmountable obstacles to reaching out.

Guess what? That's the mental illness whispering lies in your ears. Right now is when you are most at risk of buying a one way ticket to a long stay in Shitsville.

Us humans are social creatures. Even when we don't feel human, we still benefit from real contact. It can help drag us kicking and screaming out of our own heads, because too much time spent exclusively there can really drive us bonkers. It can help us realise that others care enough for us to reach out a helping hand. It can start to dispel the mental fog. It can distract us. It can even stop a major mood swing from settling in to work you over for months and months.

There's no denying - it isn't easy. In fact, it can be almost impossible. But even if we fail, at least we tried, and that helps us to realise that we have the power to reclaim the quality of life that we deserve.

An important point to keep in mind is that sometimes, despite everything we do, all of the good intentions, all of the years of wellness strategies and coping mechanisms, anything short of divine intervention, we still fall into a blubbering quivering heap.

And do you know what? Sometimes we just have to accept this and get on with surviving it until the inevitable rays of light find their way into our cave again.

This is perhaps one of the most difficult things to accept about mood disorders. They are cyclical. No matter how we feel now, and no matter all that has happened to us in the entirety of our lives, we will be up/down/fearful again. We will crawl injuriously and painfully into our caves and hunker down for a long haul.

What we need to do is to accept it, and know when to fight it and when to give in to it. That's a bloody difficult thing to do. I am only just starting out on my own journey of discovery to work out when to do what.

But acceptance is key. People like us with mood disorders do themselves so much damage by blaming themselves for something that is as unchangeable as the shape of our skulls or the intertwining of our DNA double helix.

For better or worse, this gift and curse has been given to us. That can't be changed. And it sure as heck isn't our fault. Feelings of guilt or frustration about it only serve to add to our already huge burdens, and make it even harder for us to fight our way back from our troubles.

Personally, I need to treat myself with kindness, but also hold myself to account to make sure I do not remain a constant slave to my moods.

In my experience there is no one thing that is the "magic bullet" for overcoming depression. What tends to work for me is a whole bunch of different coping mechanisms and wellness strategies.

Most of it seems to be focused around "forcing" myself to do things that my depression is telling me not to do, such as a bit of exercise, reaching out and socialising with other people, reducing the number of hours I am over-sleeping by, and so forth.

For me, distraction of any sort can help to ease the "seriousness" of it all, because that concern and anxiety about being depressed feeds back into itself, and makes the depression all the more severe and longer in duration.

I know how hard it can be when the depression just sucks all of the energy and pleasure out of your life. But even just a tiny victory of being able to get out and do something that your depression said is impossible is a major step. It proves to yourself that you can do it. It proves that the depression is not total master over you. Bit by bit, you can reclaim your life from the depression, and empower yourself to reach for the joy that we all deserve in our lives.

I know what I've just written could be perceived as mostly airy-fairy mumbo jumbo, but since I started challenging what depression was making me do - hide away in my bed for months on end, reject opportunities to socialise, avoid friends and family, wallow in my pain - my depressive episodes have been less severe and of shorter duration than at any time in my life. This is the breaking of a lifelong pattern of 30 years standing, and that is no small thing.

The challenge for each of us is finding practical and real ways that we can challenge our depression in our own lives.