Friday 30 November 2012

Glitter Jars!

If you haven't already seen this via sites like Tumblr, Glitter Jars (also known as Calm Jars) are a great craft idea for anyone looking for a soothing activity.

When you shake the jar, it's basically just very pretty.  It's an easy form of form of Distraction as part of Distress Tolerance skills, as well as a way to Self-Soothe. Double win :)

I have also heard of them used in place of self-harm, with the idea being that if you feel the urge to do so you shake the jar and commit to yourself that you won't take any action until all the glitter has settled, then repeat as necessary.

There are lots of different versions of instructions but here is my summary...

You will need:
  • Clear jar with tight sealing lid
  • Glitter, 3 - 6 tablespoons (depending on jar size)
  • Clear gel glue or clear craft glue,  approx 1 tablespoon per cup of water in jar
  • Hot or boiling water
  • Fork or anything pointy that can get messy (for stiring)
  • Food colour/dye

Add the glitter and glue to the empty jar. Fill half-way with hot water. Stir, stir, stir! When it is a totally even mixture, fill the remainder of the jar with cool water and add food colouring if you want. Glue lid shut. Allow to dry before testing.

If I'd give any extra advice, it would be to use a few different sizes of glitter, so that when the smaller pieces settle slower than the large pieces you end up with pretty layering. Also, possibly prepare to have a few attempts at this, as I know I needed to!

And lastly, be careful when opening glitter packets :(

Wednesday 28 November 2012

I Think I'm Trying To Tell Myself Something...

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.) 

1.  Sleep
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.

3.  Irritability 
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 ---

4.  EDNOS
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.

Tuesday 27 November 2012

Do Drugs Work?

There seem to be a lot of different views within the mental health community about the usefulness of medication in the treatment of BPD, and I thought I would add my one experience to the discussion.

Personally, based on my experience, I am in favour of the use of medication to assist in the management of mental illness if it is suitable.

Understandably, some people feel concerned about the idea of being "on meds" or feel there might be a stigma attached. However, I strongly believe that someone considering medication options shouldn't have to be restrained by these social or emotional pressures, and should be able to focus on the facts about what's best for them and their health.

This does not mean I am advocating that:
  • Drugs fix everything,
  • If you take medication you don't need any other therapy,
  • Everyone who feels ill should be on medication, or
  • Medication is suitable in the treatment of all mental health issues.

What I am advocating is that I frequently see it stated that "there is not much research on the effect of medication on BPD" or that "there are no medications commonly used to treat BPD" when in fact there are many people using medications to successfully help treat BPD symptoms and that there are a variety of medications that can be used.


So, now for my experience! It has taken a long time and a lot of adjustments, but the current equation of meds that I have worked out my body responds relatively well to is:

  • Pristiq (Desvenlafaxine) antidepressant, 200mg daily
    • Desvenlafaxine is an SNRI antidepressant which basically works by blocking the reuptake of key neurotransmitters, like serotonin, leaving more available to your brain. I have been taking it for two years, and the most noticable difference was at the 200mg mark, whereas you typically start at 50mg. The only side effects were that it could make it difficult to go to sleep, so I take this in the morning.
  • Valpro (Sodium Valproate) mood stabiliser, 800mg daily
    • Valpro doubles as an epilepsy medication, in that it combats seizures. For unknown reasons this also assists in managing the parts of the brain that struggle with panic and anxiety type disorders. I haven't experienced any side effects.
  • Seroquel (Quetiapine Fumarate) antipsychotic, 200mg daily
    • Many people feel uncomfortable when they hear the term "antipsychotic", but aside from treating schizophrenia and bipolar disorder, it is mostly used to augment (or enhance, improve, etc) the effects of an antidepressant. It makes you very sleepy though, so I take this at night. One side effect experienced was hand tremors, which went away after the first three and a half weeks.
  • Ativan (Lorazepam) antiaxietant, 1mg PRN
    • Lorazepam is an antiaxietant, in that it combats anxiety. "PRN" means the dosage is "as required". This means I can take it to help me fall asleep, or if I am finding my symptoms unmanageable, or if I am expecting a very stressful event or activity. As you can imagine, this is very helpful with the unpredictable nature of BPD. I have found the effects don't last longer than 12 hours and have experienced no other side effects.
  • Avanza (Mirtazapine) antidepressant, 30mg daily
    • Mirtazapine is a tetracyclic antidepressant, which just refers to its' chemical structure. This is used to augment the effects of my initial antidepressant. However, this one does make you sleepy, so I take it at night. I haven't experienced any other side effects but have only been using it for one week - so I will update this.

So how has medication helped me? All I can go on is a comparison of my moods and behaviours before and after. Before, I used to be able to continue conflicts for hours to the point of screaming and screaming until I threw up - with no regard for neighbours, police attendance or life structure. After beginning medication, I have never done this again.

It's my best guess that it seems medication has "taken the edge" off my symptoms, rather than totally "curing" them. Even though I still have horrible moods, suicidal thoughts and irrational overractions to things, it seems like these just aren't as sudden or destructive as before.

Essentially, it's like the roller coaster has slowed down a little. (I just wished it helped more with the depressive symptoms.)

But overall, given I have no major ongoing side effects, this means medication is worthwhile in treating my BPD symptoms.

I hope this gives any other sufferers out there a better idea of their options.

(This isn't to say that I am cured or that I am never going to relapse in any of these ways. The thing about medication is that your body can and will adjust to it over time. This is why it is so important to consistently take medication as per your doctor's instructions, as well as to review dosage and application along the way. In addition, I am no scientist and I write this only from the basic understanding of a consumer. Obviously, you should confirm all facts and details with your doctor when deciding what is right for you.)

Recovery


--- TRIGGER WARNING APPLIES ---

I found this image while browsing the web, and it just really struck me as how recovery feels.

Recovery isn't this gradual steady climb up a hill with guaranteed timelines of improvement until you're standing at the top saying "phew, glad that's over!"

To me, at least, recovery is ups and downs and relapse after relapse. It's like being lost in a fog and feeling so defeated at the end of each day you can't imagine starting again the next morning. But somehow there are some changes that do occur - but it's never what you plan, it's never easy, it's never logical... It sucks, basically.

And always, always, the road before you looks impossible and terrifying.

Image credit: "Til the End of Days" by Javier de la Torre